KERALA UNIVERSITY OF HEALTH SCIENCES

SYLLABUS M.Sc Nursing

2010 Admission

CONTENTS

I. II. III. IV. V.

Introduction Philosophy Aim & Objectives Selection & Admission of candidates Eligibility for appearing University examinations

VI. Universit y Ex aminations VII. Classification of results

VIII. Leave IX. X. XI. XII. XIII. Uniform Duration of the course Scheme of Examination Health Services Subjects

XIV. Annexures a) Proforma for the submission of M.Sc Nursing dissertation synopsis b) Proposal/Synopsis Outline. c) Proforma for recognition as post graduate nursing teacher. d) Proforma for the change of guide. e) Format for the submission of dissertation hard/soft copy.

INTRODUCTION
Scientific and technological advancements have created complexity in the field of nursing necessitating advanced educational preparation. To keep pace with the tremendous progress in Medical Science and to meet changing health care needs specialization and research are essential in nursing science. specialties are required: 1. Medical Surgical Nursing (Sub specialties - Cardio Vascular & Thoracic Nursing, Critical care Nursing, Oncology Nursing, Neurosciences Nursing, Nephro-Urology Nursing, Orthopedic Nursing, Gastro Enterology Nursing) 2. Obstetrics and Gynaecological Nursing 3. Child Health (Paediatric) Nursing 4. Mental Health (Psychiatric) Nursing 5. Community Health Nursing I. PHILOSOPHY The Faculty of Nursing believes that Nursing, as a health science require prompt updating of knowledge and skills in the areas of clinical specialty to render quality services and maintain collaboration with other health professionals. Postgraduate programme prepare nurses to assume leadership positions in Nursing and allied health fields as specialists, practitioners, consultants, educators, counselors, administrators and researchers in a variety of settings in meeting the health care priorities and the changing needs of the society. It encourages accountability and commitment in continuing education and also contributes to the body of knowledge in nursing through guided and independent research studies and facilitates evidence based practice. thinking and creative work. It fosters decision making, critical Hence post graduations in the following

II. AIM Aim of the postgraduate programme in nursing is to prepare graduates to assume responsibilities as Clinical Nurse Specialists, Nurse Practitioners, Consultants, Educators, Researchers and Administrators in a wide variety of professional settings.
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III. OBJECTIVES On completion of the 2 year M.Sc Nursing programme, the graduates will be able to:1. Apply the concepts, theories and principles of nursing science. 2. Demonstrate competencies in nursing practice. 3. Practice as Clinical Nurse Specialist. 4. Establish collaborative relationship with the members of other disciplines. 5. Assume leadership in various care settings. 6. Participate in health planning, implementation and evaluation at different levels of health care system. 7. Function as effective nurse educators and nurse managers. 8. Conduct independent nursing research and utilize the research findings in nursing practice and education. 9. Critically evaluate various educational programmes in nursing. 10. Demonstrate interest and positive attitude in continuing education for personal and professional growth.

Regulations
IV. Selection & admission of candidates a). Admission Annual admission for M.Sc (N) Programme should have prior sanction/ permission from the Indian Nursing Council, Kerala Nurses Midwives Council & University on the basis of clinical, physical facilities and teaching faculty. b). Eligibility Criteria/Admission Requirements: 1. The candidate should be a Registered Nurse and Registered Midwife with Kerala Nurses and Midwives Council. 2. The minimum educational requirements shall be the passing of regular degree course in Nursing (B.Sc. Nursing / B.Sc. (Hons). Nursing / Post Basic B.Sc. Nursing), with minimum of 55% aggregate marks, in an institution which is recognized by Indian Nursing Council.

3. Minimum one year of experience after Basic B.Sc. Nursing. One year compulsory nursing service/internship after successful completion of four year B.Sc Nursing can be considered as experience. 4. Minimum one year of experience prior or after regular Post Basic B.Sc. Nursing. 5. Candidate shall be medically fit. 6. Relaxation of marks for SC/ST candidates may be given as per state government norms. c). Medium of Instruction & Examinations The medium of instruction and examination shall be in English. d). Entrance/Selection test Selection of the candidates should be based on the merit of the entrance examination held by the State Government, University or competent authority. e). Eligibility Certificate from KUHAS The candidate has to make an application to the university with the following documents along with the prescribed fee to obtain an eligibility certificate issued from the University. i. ii. iii. iv. B.Sc Nursing pass / degree certificate issued by the University. One year teaching or Clinical experience / Internship certificate Permanent Registration Certificate from State Nursing Council. Certificate of Recognition of the qualifying examination in case of candidates who have passed B.Sc Nursing / Post basic

B.Sc Nursing (regular) from universities outside Kerala. v. Migration Certificate in case of candidates who have passed B .Sc Nursing / Post basic B.Sc Nursing (regular) from other universities. vi. vii. viii. ix. x. Transfer Certificate Mark list of all the examinations of the B. Sc Nursing course. Nativity Certificate Certificate to prove age. Certificate to prove community in case of SC/ST candidates.
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xi.

Any other certificate required along with the application.

A candidate who has been admitted to postgraduate course should register his/her name in the U n i v e r s i t y w i t h i n a m o n t h o f a d m i s s i o n a f t e r r e m i t t i n g t h e registration fee. Any postgraduate seats left unfilled in any specialty cannot be carried forward to the next or subsequent years. f). Migration & Transfer Migration and transfer from one college to another willnot be permitted after the student has registered with a course of study with the university. g). Fitness Certificate: Every candidate before admission to the course shall submit to the Principal of the Institution a Certificate of Medical Fitness from an authorized Medical Officer certifying that the candidate is fit to undergo the course. h). Date of Commencement of the Course The course will be deemed to have commenced on the date on which the first candidate joins the course. This date will be considered as the date of joining in the Postgraduate register maintained in the University. V. Eligibility for appearing for the examination: a). Attendance Candidate should have 80% attendance for theory and practical, with minimum 50% of internal marks in each subject both in theory & practicals. However 100% of attendance should be completed for practical before the award of degree. T h e c a n d i d a t e s h o u l d h a v e c o m p l e t e d t he t r a i n i n g p e r i o d b e f o r e t h e c o m m e n c e m e n t e x a m i n a t i o n. b). Attendance Deficit The condonation of attendance shall be done by the Principal in consultation with the College Governing Council comprising Senior Faculty of the College to a maximum of 10% to attain 80% of minimum requirements in the respective academic year subject to a maximum of one time during the whole PG programme. c). Examination fee The examination fee should be remitted for each examination appeared for. A fee as
6

of

stipulated by the University should also be remitted for the evaluation of the thesis. d). Log Book Every candidate shall maintain a l o g b o o k for recording performance of activities/ procedures/ attending/ organizing workshop/ conferences. The logbook shall be verified and certified by the Head of the Department and presented in the University practical examination. e). Periodic Tests/Internal Assessment The concerned departments may conduct tests / Internal assessment before the final examination.Three sessional examination should be conducted, out of which average of two highest marks will be taken.The marks obtained in tests /Seminar/ assignments will be maintained by the faculty of concerned department and will be made available to the University when required. The results of the periodic tests/ sessional examination conducted by the respective departments shall be displayed within 3 0 days from the d a t e o f last test. The complaints regarding award of marks, if any, have to be submitted to the Departmental Head within 5 working days from t h e d i s p l a y of the r e s u l t s . These c o m p l a i n t s s h a l l

b e e x a m i n e d b y t h e Department Committee and decisions will be taken. The Department Committee shall approve the statement of marks of the periodic tests of all the students in a year, countersigned by the principal and forwarded to the University when required. g). Dissertation Every candidate pursuing M.S c Nursi ng course is required to carry out work on a selected research project under the guidance of a recognized postgraduate teacher.The results of such a work shall be submitted in the form of a dissertation. The dissertation is aimed to train a postgraduate student in research methods and techniques. It includes identification of a problem, formulation of

h y p o t h e s e s , search and review of literature, getting acquainted with recent advances, designing of a research study, collection of data, critical analysis, and comparison of results and drawing conclusions. Every candidate shall submit to the Registrar of the University in the prescribed format a s ynopsi s cont ai ni ng part i cul a rs of proposed

di s s ert at i on work aft er obtaining ethical clearance from the Institutional Ethical
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Committee comprising principal/ Senior Professor of College of Nursing, within nine months from the date of commencement of the course on or before the dates notified by the University. The synopsis shall be sent through the proper channel. Such synopsis will be reviewed and the dissertation topic will be registered by the university. No change in the thesis topic or g uide shall be made without prior approval of the University. Tentative Schedule for dissertation S. No. 1 2 Activities Submission of the research proposal Submission of dissertation Final Scheduled Time End of 9th month of 1st year End of 9th month of IInd Year

The dissertation should be written under the following headings: i. ii. iii. iv. v. vi. vii. viii. ix. x. Introduction Objectives of the study Review of Literature Methodology Results Discussion Conclusion Summary References Annexure

The written text of dissertation shall be not less than 100 pages and shall not exceed 150 pages excluding references, tables, questionnaires, and other annexures. It should be neatly typed (font size 12-Times New Roman or font size 12-Arial) in double line spacing on one side of the bond paper (A4 size, 8.27 x 11.69) and bound properly. Spiral binding should be avoided. The Guide and the Head of the Institution shall certify the dissertation. The scientific committee of the college should scrutinize and evaluate the thesis and make required corrections if necessary and accept with modification before
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submitting to the University. Four copies of the dissertation prepared shall be submitted to the Registrar (Evaluation), on the 2 1 s t month of commencement of the course.

Hall ticket for the second year examination should be issued to the candidate only after the dissertation has been submitted to the University. A. Research Guides a) Qualification of Guide Main guide: Nursing faculty / nursing expert in the same clinical specialty holding Ph.D. /M.Phil/M.Sc. Nursing with a minimum of 3 years experience in teaching in the Post Graduate Programme in Nursing. Co-Guide: A Co-Guide is a nursing faculty/expert in the field of study (may be from outside the college but should be within the district) b) Guide Students Ratio Maximum of 1:4 (including as co-guide) Change of Guide In the event of a registered guide leaving the college for any reason or in the event of death of Guide, Guide may be changed with prior permission from the University. c) Research Committee There should be a research committee in each college comprising of minimum 5 Post Graduate Faculty chaired by the Principal, College of Nursing. VI. University Examinations Theory One internal and one external examiner will value theory answer scripts. Practicals 4 hours of practical examination per student. Maximum number of 10 students per day per specialty. The examination should be held in concerned clinical area for clinical specialties. One internal and external examiner should jointly conduct practical examination including viva voce.for each student. Examiner Nursing faculty teaching respective specialty area in M.Sc programme with minimum 3 years teaching experience after M.Sc Nursing. The examiners prior to viva should do evaluation of dissertation.
9

nursing

Duration: Viva-Voce -minimum 30 minutes per student. Classification of results: 50% pass in each of the theory and practical separately. 50-59% Second class 60-74% first class 75% and above is distinction

For declaring the rank/distinction/ First class, aggregate of 2 years marks to be considered and the candidates should have passed all the papers in the first chance. If the candidate fails in either practical or theory he/she has to reappear for both theory and practical. Maximum number of attempts per subject is three inclusive of first attempt. The maximum period to complete the course successfully should not exceed 4 years. Candidate, who fails in any subject, shall be permitted to continue the studies into the second year. However the candidate shall not be allowed to appear for the Second year examination till such time that he/she passes all subjects of the first year M.Sc nursing examination. The grading of the results of the programme shall be done at the end of Second year based on total marks secured for all years. Below 50% 50 to 59 percent 60 to 74 percent 75 percent and above Failed Passed with Second Class Passed with First Class First Class with Distinction Grade C Grade B Grade A Grade A+

Leave Candidates can avail 20 days of leave per year and not more than 7 days at a time. All students are eligible for weekly off for one day. Thus a candidate is eligible to avail a maximum of 73 days per year inclusive of 20 days leave and weekly off. Also eligible for leave supported by medical certificate subject to verification by Medical Board and recommended by the Head of Institution. Any leave over and above 73 days in a year will have to be compensated by adequate extension of the duration of the course. N. B: In Govt. Nursing Colleges, leave rules will be revised/amended as per the direction of Director of Medical Education.
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Uniform PG students have to wear prescribed uniform when they are in the clinical field.

Duration of the course Duration of the course is 2 years Weeks/year Leave Examination Total weeks available Total hours/week 48 hoursX47weeks : 52 weeks : 3 weeks (20 days) : 2 weeks : 47 weeks : 48 hours : 2256 hour/year

Total hours for 2 years: - 4512 hours Course of Instruction 1 year Nursing Education Advanced Nursing Practice Nursing Research and Statistics Clinical Specialty-I Total Theory (hrs) 150 150 150 150 600 Practical (hrs) 150 500 100 900 1650

II Year Nursing Management Nursing Research (Dissertation) *Clinical Specialty-II Total Grand Total

Theory (hrs) 150 150 300 900

Practical (hrs) 200 300 1450 1950 3600

*Clinical Specialty II

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1. Medical Surgical Nursing Sub Specialty:a. Cardio Vascular & Thoracic Nursing b. Critical care Nursing c. Oncology Nursing d. Neurosciences Nursing e. Nephro-Urology Nursing f. Orthopedic Nursing g. Gastro Enterology Nursing NB: - Of the total seats minimum 50% of the candidates should opt a sub specialty. 2. Obstetric & Gynecological Nursing 3. Child Health (Paediatric) Nursing 4. Mental Health (Psychiatric) Nursing 5. Community Health Nursing Note: Students have to maintain log book for each activity during the course of study

Scheme of Examination Theory 1st year Hours Internal Marks Nursing Education Advanced Nursing Practice 3 3 25 25 25** 25 External Marks 100 100 100* 100 4 hrs 100 100 Hours Practical Internal Marks 50 External Marks 100 275 125 125 325 850 2nd year Hours Internal Marks Nursing Management Dissertation Viva Clinical Specialty 11 3 25 100 4 hrs 100 100 325 650 Total of Ist & IInd Year
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Total

Nursing Research& Statistics 3 Clinical Specialty- 1 3

External Marks 100

Hours

Internal Marks

External Marks

Total

25

125 100 100 200

1500

* Nursing Research (External)=75Marksand Statistics( External)=25 Marks **Nursing Research (Internal)=15 and Statistics( Internal)=10 ***No separate pass minimum for Statistics.

1. There shall be one regular & one supplementary examination every year. 2. Candidate shall register for all parts of examination in their first appearance. 3. Minimum pass marks shall be 50 % in each of the Theory and practical papers separately. 4. A candidate has to pass in theory and practical exam separately in each of the paper. 5. Maximum number of candidates for all practical examination should not exceed ten per day. 6. One internal and one external examiner should evaluate dissertation and jointly conduct viva-voce for each student. 7. For Dissertation internal examiner and external examiner should be a Nursing faculty / Nursing expert in the same clinical specialty holding Ph.D./M.Phil/M.Sc. Nursing with a minimum of 3 years experience in guiding the research projects for Post Graduate students of Nursing. Health Services There should be provisions for the following health services for the students. a. An annual medical examination. b. Vaccination against tetanus, hepatitis B or any other communicable disease as considered necessary. c. A complete health record should be kept in respect of each individual student. The question of continuing the training of a student, with long term chronic illness, will be decided by a competent medical authority. d. Free medical care during illness and/ provision of health insurance.

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NURSING EDUCATION
Placement : Ist Year Hours of Instruction Theory 150 Hours Nursing Faculty-115 External Faculty- 35 Practical 150 Hours Total : 300 Hours Course Description This course is designed to assist students to develop a broad understanding of fundamental Principles, concepts, trends and issues related to education and nursing education. Further, it would provide opportunity to students to understand, appreciate and acquire skills in teaching and evaluation, curriculum development, implementation, maintenance of standards and accreditation of various nursing educational programs. Objectives At the end of the course, students will be able to : 1. Explain the aims of education, philosophies, trends in education and its impact on nursing education. 2. Describe the teaching learning process. 3. Prepare and utilize various instructional media and methods in teaching learning process. 4. Demonstrate competency in teaching, using various instructional strategies. 5. Critically analyze the existing nursing educational programs, their problems, issues and future trends. 6. Describe the process of curriculum development, and the need and methodology of curriculum change, innovation and integration. 7. Plan and conduct continuing nursing education programs. 8. Critically analyze the existing teacher preparation programs in nursing 9. Demonstrate skill in guidance and counseling. 10. Describe the problems and issues related to administration of nursing curriculum including selection and organization of clinical experience. 11. Explain the development of standards and accreditation process in nursing education programs.
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12. Identify research priorities in nursing education. 13. Discuss various models of collaboration in nursing education and services. 14. Explain the concept, principles, steps, tools and techniques of Evaluation. 15. Construct, administer and evaluate various tools for assessment of knowledge, skill, and attitude. Course Content Unit I Theory Hours 10 Content Introduction Education :Definition, aims, concepts, philosophies, Formulation of philosophy & their implications on education (Review) Impact of Social, economical, political &technological changes on education. Professional education Current trends and issues in education Educational reforms and National Educational Policy, various educational commissions-reports Nursing education- Definition, aims, phiolosophy Trends in development of nursing education in India -ANM, GNM, Basic B.Sc. Nursing, Post Basic B.Sc. Nursing, M.Sc(N) programs, M.Phil and Ph.D in Nursing, Post basic diploma programs, Nurse

practitioner programs. II 20 Curriculum Development Definition, curriculum determinants, process and steps of curriculum development, Types and framework. Educational Objectives - types, domains, levels, elements and writing of educational objectives, selection of learning experiences Organization of learning experiences; master plan, course plan, unit plan, Lesson Plan. Evaluation strategies, process of curriculum change, role of students, faculty, administrators, statutory bodies and other stakeholders. Evaluation of educational programs in nursing- course and program. Equivalency of courses : Transcript , credit system.

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III

20 *EF 10

Teaching Learning Process Concepts of teaching and learning: Definition, principles ,theories of teaching and learning, relationship between teaching and learning Competency based education, outcome based education(OBE) Instructional strategies Lecture, Discussion,

Demonstration, Simulation, Laboratory Method, Seminar, Panel, Symposium, Problem solving, Workshop, Project, role- play (sociodrama) (Review) Microteaching. Innovative Strategies Problem Based Learning (PBL), programmed instruction, Self Directed learning(SDL), Computer Assisted Instruction(CAI), computer Assisted Learning (CAL), Clinical teaching methods. Teacher - Roles & responsibilities, functions characteristics, competencies, qualities. Preparation of professional teacher Organizing professional aspects of teacher preparation programs. Critical analysis of various programs of teacher education in India IV 15 Instructional Media & Methods Key concepts in the selection and use of media in education Developing learning resource material using different Media. Instructional aids types, uses, selection, preparation, utilization. Teachers role in procuring and managing instructional Aids Projected and non-projected aids,multi media, video-tele conferencing etc

16

40 EF20

Evaluation: Concept and nature of measurement and evaluation, meaning, process, purposes, problems in evaluation and measurement, Principles of evaluation(review) characteristics-objectivity, validity, reliability, usability Formative and summative evaluation. Internal assessment, external examination. criterion and norm referenced evaluation, Evaluation strategies-meaning, characteristics. Construction of test, administration of test , scoring, grading Vs marks. Item analysis

Non-standardized tests : Essay, short answer questions and multiple choice questions, True & False, Completion.Tools of Evaluation-Rating scales, checklist,Objective Structured Clinical Examination (OSCE) , Objective Structured Practical Examination (OSPE),Viva Examination Differential scales, and Summated scales, Sociometry, Anecdotal record, Attitude scale, critical incident technique. Question bank-preparation, validation, moderation by panel.

Standardized Tools Tests of intelligence attitude, aptitude, interest, personality, achievement, socio-economic status scale, tests for special mental and physical abilities and disabilities. Teacher Evaluation-Strategies

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VI

10

Continuing Education in Nursing Concepts Definition, importance, need, scope, principles of adult learning, assessments of learning needs, priorities, resources. Program planning, implementation and evaluation of continuing education programs. Research in continuing education. Distance education in nursing.

VII

5 EF5

Guidance and counseling Concept, principles, need, difference between guidance and counseling (Review). Trends and issues in Guidance and counseling. Guidance and counseling services: diagnostic and remedial. Coordination and organization of services. Techniques of counseling : Interview, case work, Characteristics of counselor, problems in counseling. Professional preparation and training for counseling.

VIII

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Management of nursing educational institutions Planning, organizing, staffing, budgeting, recruitment, discipline, public relation, performance appraisal, welfare services, library services, hostel. Role of curriculum coordinator planning , implementation & evaluation Evaluation of educational programs in nursing- course & program Factors influencing faculty staff relationship and techniques of working together Concept of faculty supervisor (dual) position. Curriculum research in nursing.

Different models of collaboration between education & service

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IX

Quality in Nursing Education Development and maintenance of standards and accreditation in nursing education programs. Role of Indian Nursing Council, State Registration Nursing Councils, Boards and University.

* External Faculty (EF)

Activities Framing philosophy, aims and objectives. Lesson Planning. Micro teaching-2. Conduct practice teachings using different teaching strategies -10 (like lecture cum discussion, demonstration- lab method, field trips, seminars, project, role play, panel discussion, clinical methods etc) Preparation and utilization of instructional Aids using different media. Develop course plans, unit plans, rotation plans. Conduct a continuing education workshop. Annotated bibliography. Critical evaluation of any nursing education program offered by a selected institution. Planning and Organizing field visits. Construct, administer and evaluate tools (objective & essay type test, observation checklist, rating scale etc ) Observe and practice application of various non-standardized tests, (intelligence, Aptitude, Personality, Sociometry, physical & mental disabilities tests.) Methods of Teaching Lecture cum discussion Demonstration/ Return demonstration Seminar / Presentations Project work Field visits Workshop Methods of evaluation Tests
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 Presentation Project work Written assignments Internal Assessment (Theory) Weightage Test- (3 tests) Assignments Seminar/presentation 50% 25% 25%

------------------------------------------------------------------------------Total Practical Internal assessment Preparation of Learning resource material & Construction of tests/rotation plan. Practice Teaching Conduct Workshop /Short Term Course Total REFERENCE * . S. Narayana Rao ,Educational Psychology,Wiley eastern Ltd , Edition, New Delhi. Charles. E. Skinner, Educational Psychology,4th Edition, Printice Hall of India New Delhi S.K.Kochhar, Guidance and Counseling in Colleges and Universities, Revised Edition, Sterling Publishers, New Delhi. Bipin Asthana R.N.Agawal, Measurement and Evaluation in Psychology and Education, Latest Edition, Vinod Pustak Mahal, Agra. Malla Reddy Mamidi, S. Rvisankar Curriculum Development and educational Technology, Latest Edition, Sterling Publishers, New Delhi. Jagannath Mohanthy, Indian Education in the emerging Society, Latest Edition, Sterling Publishers, New Delhi. Roberth .F. Biechler, Jack Snowman, Psychology Applied to Teaching,7th Edition, Houston Mifflinco, Dallas.
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100%

25% 50% 25% 100%

 R.N.Safaya, C.S. Shukla, B.D.Bhatia, Modern Educational Psychology,9th edition, Dhanpat Rai Publishing Company, New Delhi. K.K. Bhatia, Measurement and Evaluation in Education, Latest edition, Prakash Brothers Ludhiana. Mc Graw Hill Co,New York. Richard I Arends, Learning to teach,3rd Edition, Mc Graw Hill Co, New York. Billings D M, Halstead J A (2009) Teaching in Nurisng, A guide for faculty, USA, Saunders ELSEVIER. Mayor B A & Wittman R A (2008) Nursing Education, Foundations for Practice Excellence, New Delhi, Jay Pee. Aggarwal J C (1996) Essentials of Educational Technology-Innovations in Education, New Delhi, Vikas Publishing House. Quinn M Francis (1995) Principles & Practice of Nurse Education, London, Champann & Hall. Aggarwal J C (2001) Theory & Principles of Education New Delhi, Vikas Publishing house PVT Ltd. Bevis E O (1982) Curriculum Builders in Nursing, St. Louis, C. V Mosby Company. Aggarwal J C (2008) Development & Planning of Modern Education, New Delhi, Vikas Publishers PVT Ltd. Emerson R J (2007) Nursing Education in the clinical setting, St. Louis, Mosby. Young. . E & Peterson B. L (2007) Teaching Nursing Developing a student centered environment New York, Lippincott. Devi E S (2006) Manipal manual of Nursing Education New Delhi, CBS Publishers & Distributors. Singh T Etal (2009) Principles of Medical Education New Delhi, Jaypee. Clement, Textbook on Communication & Educational Technology. Barbare A Moyer and Ruth a Wittman, Nursing Education, Foundation for practice Excellence, Jaypee Brothers. Bistable S B (2010), Nurse as Educator, New Delhi, Jones and Bartlett Publishers. Iwasiv C L etal(2010), Curriculum development in Nursing Education, New Delhi, Bartlett Publishers. Pramilaa R (2008), Nursing Communication and Educational Technology Bangaluru, Jaypee Brothers.
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Note:- * Latest Edition *******

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ADVANCED NURSING PRACTICE

Placement: 1st Year Hours of Instruction Theory: 150 Hours External Faculty:-30hrs Nursing Faculty:-120hrs Practical: 500 Hours Total Course Description The course is designed to develop an understanding of concepts and constructs of theoretical basis of advance nursing practice and critically analyze different theories of nursing and other disciplines. Objectives: At the end of the course the students will be able to: 1. Describe ethical, legal, political and economic aspects of health care delivery and nursing practice. 2. Identify latest trends in nursing and the basis of advanced nursing practice. : 650 Hours

3. Explain bio- psycho- social dynamics of health, life style and health care delivery system. 4. Discuss concepts, principles, theories, models, approaches relevant to nursing and their application. 5. Perform health assessment and General physical examination 6. Provide holistic and comprehensive care following nursing process approach 7. Perform extended and expanded role of nurse. 8. Describe alternative modalities of nursing care. 9. Describe the concept of quality control in nursing. 10. Identify the scope of nursing research. 11. Use computer in patient care delivery system and nursing practice. 12. Appreciate importance of self development and professional advancement.
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COURSE CONTENT Unit Hours Content

Nursing as a Profession Review: History and development of nursing profession, Perspectives of Nursing Profession-National, global Code of ethics, code of professional conduct, autonomy and accountability, assertiveness, visibility of nurses, legal considerations, Role of regulatory bodies Professional organizations and unions-self defense, individual and collective bargaining Evidence Based Nursing Practice Progressive Patient Care Quality assurance in nursing (INC). Futuristic nursing.

II

Health care delivery Health care environment, Health economics Health care policy -National, State Policy and politics in Nursing Health care delivery system- national, state, district and local level. Major stakeholders in the health care system-Government, NGOs etc Patterns of nursing care delivery in India. Health care delivery concerns National health and family welfare programs:(Review) Information, education and communication (IEC). Tele-medicine.

111

20

Philosophy and Theories of Nursing Values, Conceptual models, approaches. Nursing theories: Nightingales, Hendersonss, Rogers, Peplaus, Abdellas, Lewines, Orems, Johnsons, Kings, Neumans, Roys, Watson parse, etc and their applications Health belief models
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 1V 12 *EF8

Evidence based practice model.

Clinical Assessment-History taking and physical examination

Nursing process Review: Identification of health-illness problems, health behaviors, Methods of data collection, analysis and utilization of data relevant to nursing process. Formulation of nursing care plans, health goals, Implementation, modification and evaluation of care.

V1

15 EF10

Genetics Molecular basis of the gene and transmission of genetic information Recombination, Mutation, Pedigree analysis Mapping the Human genome Genome project. Approaches to common genetic disorders-Monogenic and polygenic Genetic testing basis of genetic diagnosis, Pre symptomatic and predisposition testing, Prenatal diagnosis & screening, Ethical, legal & psychosocial issues in genetic testing. Genetic counseling. Practical application of genetics in nursing.

V11

4 EF2

Epidemiology Review :Epidemiological approach and methods Concepts of causation of diseases and their screening, Application of epidemiology in health care delivery Health surveillance and health informatics Role of nurse

V111

30

Bio-Psycho social pathology Review: Biological and Psychodynamics of disease causation Life processes, Homeostatic mechanism, psycho-social dynamics in causation of disease, life style disease Common problems and management: Infection, Oxygen insufficiency, Fluid and electrolyte imbalance, Acid Base imbalance, Metabolic syndrome, Immune disorders, Hemorrhage, shock,
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Altered body temperature, Unconsciousness, Insomnia, pain, Sensory deprivation, Immobility, Anaphylaxis, Septicemia, Cardio pulmonary arrest. IX 15 EF5 Psychological aspects and Human relations Review:Human behavior, Personality trait, Communication and interpersonal relationships, Individual / group dynamics and organizational behavior, Basic human needs X 10 Human Sexuality and sexual health. Stress and adaptation, crisis and its intervention, Coping with loss, death and grieving, Principles and techniques of Counseling.

Nursing practice Framework, scope and trends. Alternative modalities of care Alternative systems of health and complimentary therapies. Extended and expanded role of the nurse, in promotive, preventive, curative and restorative health care delivery system in community and institutions. Health promotion and primary health care. Independent practice issues, Independent nurse-midwifery practitioner. Collaboration issues and models-within and outside nursing. Models of Prevention Gender sensitive issues and women empowerment. Disaster nursing. Geriatric considerations in nursing. Trans-cultural nursing.

XI

15

Advanced nursing skills Definition, Indication and nursing implications: TPN, Hemodynamic monitoring, Endo-tracheal intubation, Tracheotomy, Mechanical ventilation, Pacemaker, Hemodialysis, Peritonial dialysis, LP, Chest physio therapy, Pleural and abdominal paracentesis, Triage, Pulse oxymetry, CPR, ACLS

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XII

10 EF5

Computer applications for patient care delivery system and nursing practice Use of computers in teaching, learning, research and nursing practice. Windows, MS office: Word, Excel, Power Point Internet-literature search, Statistical packages Hospital management information system: softwares

Legend: *EF-External Faculty Practical 500 Hrs Clinical posting in the following areas: Sl. No 1. 2. 3. 4. Medical and Surgical Wards ICUs Community Health Centre/ PHC Casualty Total Activities Prepare Case studies with nursing process approach and theoretical basis Care Analysis 2 Practice advance clinical procedures Presentation of comparative picture of theories Clinical presentations- 5 Annotated bibliography Methods of Teaching Lecture cum discussion Seminar Panel discussion Debate Case Presentations Exposure to scientific conferences Methods of evaluation: Tests
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Dept/Unit

No. of Weeks

4 4 2 1 11

 Presentation Seminar Written assignments Advance Nursing Procedures Definition, Indication and nursing implications: Cardio Pulmonary Resuscitation, Total Parentral Nutrition, Hemodynamic monitoring, Endotracheal intubation, Tracheostoma, mechanical ventilation, Pacemaker, Hemodialysis, Peritonial dialysis, Lumbar Puncture, Blood Transfusion Pleural and abdominal parecentasis Operation Room techniques, Health assessment, Triage, Pulse oxymetry. Internal Assessment Theory Test- (3 tests) Assignment Seminar/presentation Weightage 50% 25% 25% 100% REFERENCE *: Moyet Carpenito, Nursing Diagnosis. Lippincott.Latest edn . Tucker,Susan Martin etal. Patient Care Standards Latest edn .Mosby. Guyton ettall, Textbook of Medical Physiology Latest edn .Saunders. Gordin ,Janet W. Nursing Diagnosis Latest edn Jones and Bartlett Publishers. Anne M Barker, Advance Practice Nursing edited by AnneM Barker, Johns and Bertlett Publishers, New Delhi Lemone ,Lillis ,Taylor , Fundamentals of Nursing Latest edn . Wilson,Jennie Infection control in Clinical Practice .Latest edn Bailliere Tindal. Ciliska ,Dicenso ,Guyatt .Evidence based Nursing Elsevier . Speakman,Alizabeth , Body fluids and electrolytes Latest edn . BerMn ,Snyder,Kozier,erb, Fundamentals of Nursing, Latest edn . Ann Marriner Tomey, Nursing Theorist and Their Work, Latest edn, Mosby, Elsevier. Martha Raila Alligood, Ann Marriner Tomey, Nursing Theory Utilization & Application, Elsevier. Dee Mc Gonigle, Kathleen Mastriau,, Nursing Informatics & Foundations of Knowledge, Jones & Bartlett Publishers New delhi.
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 Catheleene Masters, Role development in Professional Nursing Practice, Jones & Bartlett Publishers Boston. Janie B Butts Karen L Rich, Nursing ethics across the curriculum and into practice. Lewis, Heitkemper, Dirksen O Brien Brcher, Medical Surgical Nursing,Latest edn, Mosby Publishers. G M Dhar, I Robbani, Foundations of Community Medicine, Latest edn, Elsvier Publishers.

Note:- * Latest Edition

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NURSING RESEARCH AND STATISTICS

Placement: 1st Year

Hours of Instruction Theory Practical Total Part A: Nursing Research : 150 Hours : 100 Hours : 250 Hours

Theory : 100 Hours Practical: 75 Hours Total Course Description: The course is designed to assist the students to acquire an understanding of the research methodology and statistical methods as a basis for identifying research problem, planning and implementing a research plan. It will further enable the students to evaluate research studies and utilize research findings to improve quality of nursing practice, education and management. General Objectives: At the end of the course, the students will be able to: 1. Recognize the significance of research in nursing and its importance in evidence- based nursing practice. 2. Identify the steps of quantitative and qualitative research. 3. Discuss the ethical aspects of research. 4. Review literature utilizing various resources. 5. Identify researchable problems in nursing. 6. Demonstrate skill in planning and conducting research studies. 7. Communicate research findings. 8. Utilize research findings. 9. Critically evaluate research reports and articles. 10. Write scientific paper for publications. : 175 Hours

30

COURSE CONTENT: Unit I Theory hours 5 Content Introduction Review: Problem solving and scientific method. Research definition, characteristics, purposes, types of research, Basic research terms, Scope of nursing research, Overview of Research process, Significance of research in nursing, Historical Evolution of nursing research. II 5 Review of Literature Review Importance, purposes, sources, criteria for selection of resources Guidelines for writing literature review. Future trends in nursing research. Problems and challenges in nursing research, health and social research. Priorities for nursing research. Evidence based practice. Ethics in research 5 Literature search-web search Practic al hours Content

31

III

10

Research problem: Identification of research problem/ research question. Formulation of problem statement and research objectives Definition of terms Assumption and delimitations Identification of variables Hypothesis definition, formulation and types. 5 1. Identification of research question. 2.Formulation of problem statement and research objectives

IV

Developing theoretical /conceptual framework. Theories: Nature, characteristics, purpose and uses Using, testing and developing conceptual framework, models and theories. 5 Developing theoretical /conceptual framework.

15

Research Approach and designs Qualitative and Quantitative. Qualitative research approaches: Grounded theory, phenomenology, ethnography, case study and historical research. Quantitative: Experimental and non experimental: types, characteristics, advantages and disadvantages.

VI

8 Sampling Population and sample. Factors influencing sampling Sampling techniques Sample size Probability and sampling error

32

VII

20

a) Data collection methods and Tools: Concepts of data collection, Data sources, methods/techniques quantitative and qualitative. Tools for data collection-types and characteristics b) Measurement and data quality Validity and reliability of tools, Characteristics of an instrument Steps in development of an instrument. Procedure for data collection

VIII

Critical analysis of research reports and articles

15

IX

Developing and presenting a research proposal

Critical analysis of research reports and articles Presenting a research proposal

Implementing research plan Pilot study, review research plan (design), planning for data collection, administration of tool/interventions, Collection of data

40

Pilot study

XI

10

Analysis and interpretation of data Plan for data analysis: quantitative and qualitative Preparing data for computer analysis and presentation Statistical analysis Interpretation of data Conclusion and generalizations Summary and discussion

XII

10

Reporting and utilizing research findings: Communication of research results; oral and written Writing research report purposes, methods and style, Vancouver, American Psychological Association (APA), Campbell etc.
33

Utilization of research findings. Writing scientific articles for publication: purposes &Style Activities: Annotated Bibliography of research reports and articles. Review of literature of selected topic and reporting Formulation of problem statement, objective and hypothesis Developing theoretical /conceptual framework. Preparation of a sample research tool. Analysis and interpretation of given data Developing and presenting research proposal Journal club presentation Critical evaluation of selected research studies Writing a scientific paper

Methods of Teaching: Lecture-cum-discussion Seminar/Presentations Project Class room exercises Journal club

Methods of Evaluation: Quiz, Tests(Term) Assignments/Term paper Presentations Project work (Concerned specialty)

Internal Assessment Techniques Term test (2 tests) Assignments Presentations Project work Total

Weightage (35 marks) 40% 20% 20% 20% 100%

34

Part B: Statistics (External Faculty)

Hours of Instruction Theory Practical Total Course Description: At the end of the course, the students will be able to develop an understanding of the statistical methods and apply them in conducting research studies in nursing 50Hours 25 Hours 75 Hours

General Objectives: At the end of the course the students will be able to: 1. Explain the basic concepts related to statistics 2. Describe the scope of statistics in health and nursing 3. Organize, tabulate and present data meaningfully 4. Use descriptive and inferential statistics to predict results

5. Draw conclusions of the study and predict statistical significance of the results 6. Describe vital health statistics and their use in health related research 7. Use statistical packages for data analysis. COURSE CONTENT Unit Hours Theory I 7 Practical Introduction: Concepts, types, significance and scope of statistics, meaning of data Sample, parameter Type and levels of data and their measurement Organization and presentation of data-Tabulation of data Frequency distribution Graphical and tabular presentations II 4 Measures of central tendency: Mean, Median, Mode
35

Course content

III

Measures of variability: Range, Percentiles, Average deviation, Quartile deviation, Standard deviation

IV

Normal Distribution: Probability, Characteristics and application of normal probability curve, Sampling error

Measures of relationship: Correlation-need and meaning Rank order correlation Scatter diagram method Product moment correlation Simple linear regression analysis and prediction

VI

Designs and meaning: Experimental designs Comparison in pairs, randomized block design, Latin squares.

VII

Significance of Statistic and Significance of difference between two Statistics(Testing hypothesis) Non parametric test-Chi-square test, Sign, median test, Mann Whitney test Parametric test-t test, ANOVA, MANOVA, ANCOVA

VIII

Use of statistical methods in psychology and education: Scaling-Z Score, Z Scaling Standard Score and T Score Reliability of test scores: test-retest method, parallel forms split half method
36

IX

Application of statistics in health: Ratios, Rates, Trends Vital health statistics Birth and death rates Measures related to fertility, morbidity and mortality

20

Use of Computers for data analysis Use of statistical package

Activities: Exercises on organization and tabulation of data Graphical and tabular presentation of data Calculation of descriptive and inferential statistics (chi square, ttest, correlation) Practice in using statistical package Computing Vital health statistics

Methods of Teaching: Lecture-cum-discussion Demonstration-on data organization, tabulation, calculation of statistics, use of statistical package, Classroom exercises, organization and tabulation of data Computing Descriptive and inferential statistics; vital and health statistics and use of computer for data entry and analysis using statistical package Methods of Evaluation: Test, Classroom statistical exercises weightage 15 marks 100%

Internal Assessment Techniques Test (2 tests)

37

References *: Burns.N. and Susan K Grove. Understanding Nursing Research building and evidence based practice., W B Saunders, St. Luis . Polit, D.F. and C T Beck. Nursing Research Generating and Assisting evidence for Nursing practice-Wolter Kluwer, New Delhi Wood, G.L. and Haber J. Nursing Research-methods and critical appraisal for evidence-based practice. Elsevier. C R Kothari. Research Methodology Methods and Techniques. New Age Publishers, New Delhi. Sunder Rao. P.S.S. Jesudian, G. and Richard, J. An introduction to Biostatistics a manual for students in health sciences. Rose A Utely. Theory and Research for Academy Nurse Educators Application to Practice, Jones and Bartlett Publishers.Boston Nola A.Schmidt, Janet M Brown. Evidence Based Practice for Nurses Appraisal and Application of Research, Jones and Bartlett Publishers, New Delhi. Marylynn J Wood, Jannet C Ross Kerr. Basic Steps in Planning Nursing Research from question to Proposal, Jones and Bartlett Publishers, New Delhi. Mahajan. Methods in Biostatistics. Jaypee Brothers

Note:- * Latest Edition

38

CLINICAL SPECIALITY I MEDICAL SURGICAL NURSING-I

Placement: 1st Year Hours of instruction Theory: 150 Hours Nursing Faculty: 120Hours ExternalFaculty: 30 Hours Practical: 900 Hours Total: 1050 Hours Course Description It is designed to assist students in developing expertise and in-depth knowledge in the field of Medical Surgical Nursing. It will help students to appreciate the patient as a holistic individual and develop skill to function as a specialized Nurse. It will further enable the student to function as educator, manager and researcher in the field of Medical Surgical Nursing. Objectives At the end of the course the students will be able to: 1. Appreciate the trends & issues in the field of Medical Surgical Nursing as a specialty. 2. 3. 4. 5. 6. Apply concepts & theories related to health promotion. Appreciate the client as a holistic individual. Perform physical, psychosocial assessment of Medical Surgical patients. Apply Nursing process in providing care to patients. Integrate the concept of family centered nursing care with associated disorder such as genetic, congenital and long-term illness. 7. 8. Recognize and manage emergencies Describe various recent technologies & treatment modalities in the management of critically ill patients. 9. 10. 11. 12. 13. 14. Appreciate the legal & ethical issues Prepare a design for ICU Appreciate the role of alternative systems of Medicine in care of patients. Incorporate evidence based Nursing practice and identify the areas of research Recognize the role of Nurse practitioner as a member of the health team. Conduct clinical Teaching for undergraduate nursing students & in-service nurses.
39

COURSE CONTENT: Unit 1 Hours 2 Content Introduction: II 2 Historical development of Medical- Surgical Nursing Trends & issues in Medical Surgical Nursing. Ethical & cultural issues in Medical Surgical Nursing.

Review: General Health Assessment & History taking. Nutritional assessment.

III

10 (EF 3)

Management of patients with disorders of Gastro intestinal system Review: Functional anatomy and physiology. Health assessment- History taking, physical examination, diagnostic investigations Etiology, pathophysiology diagnostic tests & management of GERD, APD, Intestinal obstruction, , Pancreatitis, GI Bleeding, Irritable Bowel Syndrome, , HEPATITIS, Toxic and drug induced liver disease, Portal hypertension, Cirrhosis of Liver, Hepatic Failure, leptospirosis Related research studies & Evidence based nursing practice. Rehabilitation and follow-up.

IV

12 (EF 3)

Management of patients with disorders of nervous system Review: Functional anatomy and physiology. Health assessment- History taking, physical examination, diagnostic investigations Etiology, pathophysiology diagnostic tests & management of Dementia, Stroke, Meningitis, Encephalitis, Epilepsy, ICSOL. Related research studies & Evidence based nursing practice. Rehabilitation and follow-up.

12 (EF 3)

Management of patients with disorders of respiratory system Review: Functional anatomy and physiology. Health assessment- History taking, physical examination , diagnostic investigations Etiology, pathophysiology diagnostic tests & management of Asthma, Infections, COPD, ARDS, Respiratory Failure, Pulmonary edema, Pulmonary embolism, Pulmonary neoplasm
40

 Related research studies & Evidence based nursing practice. Rehabilitation and follow-up. VI 12 (EF5) Management of patients with disorders of cardio vascular system Review: Functional anatomy and physiology. Health assessment- History taking, physical examination , diagnostic investigations Etiology, pathophysiology diagnostic tests & management of Hypertension, CAD, Acute coronary syndrome, Arrhythmias , CCF, Disorders of arteries & veins. Related research studies & Evidence based nursing practice. Rehabilitation and follow-up. VII 12 (EF 3) Management of patients with disorders of blood Review: Functional anatomy and physiology. Health assessment- History taking, physical examination , diagnostic investigations Etiology, pathophysiology diagnostic tests & management of Anemias, Leukemias, Hemorrhagic Disorders. Related research studies & Evidence based nursing practice. Rehabilitation and follow-up. VIII 15 (EF3) Management of patients with disorders of genito- urinary system Review: Functional anatomy and physiology. Health assessment- History taking, physical examination , diagnostic investigations Etiology, pathophysiology diagnostic tests & management of Renal Calculi, UTI, Nephritis, Nephrotic Syndrome, ARF,CRF,BPH, Ca bladder. Related research studies & Evidence based nursing practice. Rehabilitation and follow-up. IX 15 (EF3) Management of patients with disorders of endocrine system Review: Functional anatomy and physiology. Health assessment- History taking, physical examination , diagnostic investigations Etiology, pathophysiology diagnostic tests & management of DM, Pituitary disorders, Thyroid parathyroid and adrenal dysfunctions.
41

 Related research studies & Evidence based nursing practice. Rehabilitation and follow-up. X 15 (EF 3) Management of patients with disorders of muscular-skeletal system Review: Functional anatomy and physiology. Health assessment- History taking, physical examination , diagnostic investigations Etiology pathophysiology diagnostic tests & management of Arthritis, SLE, Osteoporosis, Osteomalacia, Osteomyelitis, Fracture, Gout. Related research studies & Evidence based nursing practice. Rehabilitation and follow-up. XI 4 Management of patients with disorders of Integumentary System Health assessment- History taking, physical examination , diagnostic investigations Etiology pathophysiology diagnostic tests & management of herpes psoriasis, dermatitis, pemiphigus, cellulites, leprosy, skin cancer, pressure ulcer. Related research studies & Evidence based nursing practice. Rehabilitation and follow-up. XII 4 Management of patients with disorders of Eye and ENT Review: Functional anatomy and physiology. Health assessment- History taking, physical examination, diagnostic investigations Etiology pathophysiology diagnostic tests & management of hearing impairment, infections disorders of balance glaucoma, cataract, corneal disorders, tumors, refractive errors, visual impairment. Related research studies & Evidence based nursing practice. Rehabilitation and follow-up. XIII 15 Geriatric nursing Ageing; Demography, Concepts and theories of ageing Age related body systems changes.
42

 XIV 10

Psychosocial Aspects of Aging. Stress & coping in older adults. Nursing Assessment-History and Physical assessment. Medications and elderly. Common Health Problems & Nursing Management Psychosocial and Sexual abuse of elderly. Use of aids and prosthesis Legal & Ethical Issues.

Management of patients with communicable and sexually transmitted diseases: Review of immune system. Common Disorders of immune system HIV/AIDS. Review of infection process cycle, Etiology, Patho physiology, Clinical manifestations, complications, prognosis, investigation and diagnostic assessment, Treatment modalities of acute diarrhoeal disorders, typhoid fever, hepatitis, tetanus, rabies, malaria, Japanese encephalitis. Emerging communicable diseases

XV

10 (EF 4)

Emergency, trauma and multi-system organ failure DIC (disseminated intravascular coagulation) Burns, poisoning Health assessment-History taking, physical examination, investigation and diagnostic assessment and management of craniocerebral trauma, spinal cord injury and abdominal injuries. Related research studies. Evidence based nursing practice. Rehabilitation and follow-up.

Sl. No 1. 2. 3. 4. 5.

Dept/Unit General Medical Ward General surgical ward ICUs Oncology Emergency Department Total

No. of Weeks 4 4 7 2 2 19

43

Student Activities: Clinical presentations Health Assessment Nutritional Assessment Health Education related to disease conditions Case studies Term paper

Theory weightage Sessional exams -3 Written assignments

50% 25% 25%

Practical weightage Ongoing assessment Clinical assignments Internal examination

50% 30% 20%

Seminars/Presentations Total References: Monahaa,Frances Donovan.phipps Medical Surgical Nursing.8th edn.Mosby. Smeltzer ,Suzanne.C Brunner and Suddarths Text book of Medical surgical Nursing.11th edn :Lippincott. Lewis. Medical Surgical Nursing Assessment & Management of Problems, 7th Edn. Mosby Publishers. Joyce M Black. Medical Surgical Nursing-Clinical Management for positive outcomes, 7th Edn. Saunders, Mossouri. Darovic ,Gloria Oblouk Hemodynamic monitoring W.B.Saunders 3rd edn. Barker,Ellen.Neuroscience Nursiing 2nd edn. Mosby. Greene; Netters Orthopedics W.B.Saunders Libby etal, Braunwalds heart disease8th edn. Elsevier Jarvis, Carolyn. Physical Examination and Health Assessment.5th edn.Saunders Sole,Mary Lou, Introduction to critical care Nursing 4th edn .Elsevier Albert,Richard K.etal ,clinical critical care Medicine.Mosby. Swash,Michael Hutchisons clinical methods.saunders ,22nd edn. Ried,robin.Pathology illustrated 6th edn.Elsevier. Dave P.K.Emergency medical services and disaster management. Jaypee. Floch,Martin H.etal.Netters Gastro-entrology.Icon learning systems. Wadia,Noshir H.Neurological practice.Elsevier
44

100%

TOTAL

100%

 Mahur Ann B. Orthopedic Nursing 3rd edn Saunders. Terrill Bobbee ,Renal Nursing Ausmed publications. Kristian L Mauk. Gerentological Nursing, 2nd edn, Jones and Bartlett Publishers. Vinod K Sharma. Geriatric Care, Text Book of Geriatrics & Gerontology, III Edn, Viva Books. Phipps, Long, Wood. Shafers Medical Surgical Nursing.VII edn. B.I Publications, New Delhi. Gubney. Clinical Nutrition. Dhenagara. Diseases of Ear,Nose and Throat. IV Edn. Saunders. Muhammed Maqbool. Text book of Ear Nose Throat Diseases XI edn, Jaypee Publishers. H V Nema & Nitin Nema. Text Book of ophthalmology. 5th edn. Jaypee Rose Ann O Shea. Principles & Practice of Trauma Nursing, I edn, Elsevier. Brigid Breckman. Stoma Care & Rehabilitation I edn, Elsevier. Sue Bale & Vanessa Jones. Wound Care Nursing. II edn, Mosby. Thomas O Habif. Skin disease Diagnosis & Treatment. II edn. Mosby. K V krishnadas.,Text Book of Medicine, 5th edn, Jay pee. Nicholas A Boon etal. Davidsons Textbook of Medicine, 20th edn, Elsevier. Scott H Plantz, E John Wipfler NMS Emergency Medicine, II edn, Lippincott Williams & Wilkins.

45

CLINICAL SPECIALTY I CHILD HEALTH (PAEDIATRIC) NURSING-I

Placement : Ist Year Hours of Instruction Theory 150 Hours ExternalFaculty- 50 Hours Internal Faculty- 100 Hours Practical-900Hours Total : 1050 Hours Course Description This course is designed to assist students in developing expertise and in depth understanding in the field of Child Health Nursing. It will help students to appreciate the child as a holistic individual and develop skill to function as neonatal and child health nurse specialist. It will further enable the student to function as educator, manager, and researcher in the field of Pediatric nursing. Objectives At the end of the course the students will be able to: 1. Appreciate the history and developments in the field of child health and child health nursing as a specialty. 2. Apply the concepts of growth and development in providing care to the pediatric clients and their families. 3. 4. 5. Perform physical, developmental, and nutritional assessment of pediatric clients Apply nursing process in providing nursing care to neonates & children Integrate the concept of family centered pediatric nursing care with related areas such as genetic disorders, congenital malformations and long term illness. 6. 7. Appreciate the legal and ethical issues pertaining to pediatric and neonatal nursing Describe various recent technologies and treatment modalities in the management of high risk children.

46

8.

Incorporate evidence based nursing practice and identifies the areas of research in the field of pediatric/neonatal nursing

9.

Recognize the role of pediatric nurse practitioner as a member of the pediatric and neonatal health team.

10. Teach pediatric nursing to undergraduate students & in-service nurses. Course Content Unit I Hours 5 Introduction Review: Historical development of Pediatrics and Pediatric Nursing in India; Current status of child health in India; Trends in Pediatrics and Pediatric Nursing, Ethical and cultural issues in pediatric care Rights of children National health policy for children, special laws and ordinances relating to children. National goals, Five year plans, National health programs related to child health II 10 EF 5 Assessment of pediatric clients History taking Developmental assessment Physical assessment Nutritional assessment Family assessment III 5 Hospitalized child Review:- Meaning of hospitalization to the child, preparation for hospitalization, effects of hospitalization on the child and family Stressors and reactions related to developmental stages, play activities for ill hospitalized child.
47

Content

Nursing care of hospitalized child and family -principles and practices

IV

10 EF 5

Pre-natal Pediatrics Embryological and fetal development, Prenatal factors influencing growth and development of fetus, Genetic patterns of common pediatric disorders, chromosomal aberrations, genetic assessment and counseling legal and ethical aspects of genetic screening and counseling role of nurse in genetic counseling, Importance of prenatal care and role of pediatric nurse.

10

Growth and Development of children Review: -Factors affecting growth and development Principles of growth and development, Concepts and theories of growth and development, Developmental tasks and special needs from infancy to adolescence, developmental milestones, Assessment of growth and development of pediatric clients Developmental Problems

VI

10 EF 5

Behavioral Pediatrics and Pediatric Nursing Parent child relationship, Basic behavioral pediatric principles and specific behavioral pediatric concepts/disorders- maternal deprivation, failure to thrive, child abuse, battered child syndrome, Common behavioral problems and their management, Child guidance clinic.

VII

10 EF 5

Preventive Pediatrics and Pediatric Nursing Concept, aims and scope of preventive pediatrics, Maternal health and its influence on child health, antenatal aspects of preventive pediatrics, Immunization, expanded program on immunization/
48

universal immunization program and cold chain, Nutrition and nutritional requirements of children, changing patterns of feeding, baby- friendly hospital initiative and exclusive breast feeding, Health education, nutritional education for children and mother Nutritional programs National and international organizations related to child health, Role of pediatric nurse in the hospital and community. VIII 10 EF 5 Developmental disturbances and implications for nursing Adjustment reaction to school, Learning disabilities Habit disorders, speech disorders, Conduct disorders, Early infantile autism, Attention deficit hyperactive disorders (ADHD), depression and childhood schizophrenia IX 10 Challenged child and implications for nursing Physically challenged, causes, features, early detection & management Children with cerebral palsy Mentally challenged child. Training & rehabilitation of challenged children X 5 Crisis and nursing intervention The hospitalized child, Terminal illness & death during childhood Nursing intervention-counsiling XI 5 EF 5 Drugs used in Pediatrics Criteria for dose calculation Administration of drugs, oxygen and blood Drug interactions Adverse effects and their management

49

XII

40 EF 20

Neonatal Nursing New born baby: Concept, Goals, assessment, principles. - profile and characteristics of the new born, Nursing care of the new born at birth, care of the new born and family, Assessment of gestational age IUGR babies High Risk Newborn: Identification, classification and nursing management. Nursing management of Preterm, term neonate and growth retarded babies. Post-mature infant, and baby of diabetic and substance use mothers. Respiratory conditions, Asphyxia neonatorum, neonatal apnoea meconium aspiration syndrome, pneumo thorax, pneumo mediastinum Icterus neonatorum. Birth injuries. Hypoxic ischaemic encephelopathy Congenital anomalies. Neonatal seizures. Neonatal hypocalcaemia, hypoglycemia, hypomagnesaemia. Neonatal heart diseases. Neonatal hemolytic diseases Neonatal infections, neonatal sepsis, opthalmia, neonatorum, cogenital syphilis, HIV/AIDS Advanced neonatal procedures. Calculation of fluid requirements. Hematological conditions erythroblastosis fetalis, hemorrhagic disorder in the newborn

XIII

20

IMNCI (Integrated management of neonatal and childhood illnesses) Essential New born care, facility based new born care

Practical Experience Total = 900 Hours 1 Week = 48Hours

50

Sl. No 1. 2. 3. 4. 5. 6. 7.

Dept/Unit Pediatric Medical Ward Pediatric Surgical Ward Labor Room/ Maternity ward NICU/Newborn Nursery Community Paed. O.P.D Child guidance clinic Total

No. of Weeks 5 2 1 8 1 1 1 19

Visit to Creche, Child Guidance Clinic, Anganwadi, Orphanage, Child Care Center, Play school, Special schools for challenged children. Procedures to be performed/ assisted Assessment of Neonates: Identification & assessment of risk factors, APGAR Score, gestation age, Anthropometric assessment, Admission & discharge of neonates Feeding - management of breast feeding, artificial feeding, expression of breast milk, NG(Nasogastric) tube insertion, gavage feeding, TPN, Breast feeding counseling Thermoregulation- Axillary temperature, Kangaroo Mother Care (KMC), Use of Radiant warmer, incubators, management of thermoregulation & control Administration of Drugs: I/M, IV injection, IV Cannulation & fixation infusion pump, Calculation of dosages, Neonatal formulation of drugs, use of tuberculin/ insulin syringes, Monitoring fluid therapy, Blood administration. Procedures for prevention of infections: Hand washing, disinfections & sterilization, fumigation Collection of specimens Setting, Use & maintenance of basic equipment: Ventilator, O2 analyzer, monitoring equipment, Photo therapy unit, Flux meter, Infusion pump, Radiant warmer, incubator, Centrifuge machine, Bilimeter, Refractometer, laminar flow Umbilical catheterization arterial and venous Arterial B P monitoring Blood transfusion- exchange transfusion full and partial Chest tube insertion Endotracheal intubation Ventilation
51

Assist in surgery

Student Assignments Care analysis Clinical presentations Growth & developmental assessment Assessment & prescription of nursing interventions for sick children Health education related to disease conditions Nutritional assessment Project work Field visits Maintaining Log book. Theory weightage Sessional exams (3) Written assignments Seminars Total 50% 25% 25% 100% Practical weightage Ongoing clinical evaluation Clinical assignments Internal practical examination Total 40% 40% 20% 100%

REFERENCES Avery,Fletcher and Mac Donald (1999). Neonatology- Pathophysiology, Management of Newborn 5th edn. Lippincott Co. Behrman, Klieg man & Jenson (2004) Nelson Textbook of Paediatrics 18 th edn. Edwards, Hertzberg, Haya & Youngblood( 1999). Pediatric Rehabilitation Nursing, W.B Saunders Co. Ghai,Piyush and Paul (2006). Practical Paediatrics. 6th edn.CBS Publishers, New Delhi. Gupte, S.(2004). The Short Textbook of Paediatrics. 10th edn.Jaypee Brothers. Hockenbery, Wilson, Winlelstein & Kline(2004). Wongs Nursing Care o9f Infants and Children.7th edn.Elsevier. Johnston, G.B (2000). The newborn Child- 9th edn. Churchill Livingstone. Joshi, N.C.(2007). Clinical Paediatrics. Elsevier Pvt. Ltd. Kulkarni, M.L (2005). Clinical Methods in Paediatrics- Physical examination of children. Vol.1,2,&3, Jaypee brothers. Lissauer & Clayden (2007). Illustrated Textbook of Paediatrics. 3rd .edn.
52

 Marlow & Redding (2008). Textbook of Pediatric Nursing.6th edn. Saunders. Co. Robertson D.M & South, M(2000). The newborn Child- 9th edn.Churchill Livingstone. Skale, N.(1999). Manual of Pediatric Nursing Procedures. J.B. Lippincott Co. Williams ,C & Asquith, J.(20000. Paediatric Intensive Care Churchill livingstone Nursing. 2nd Edn.

Wong, D.L (2005).Whaley & Wongs Nursing care of Infants and Children 7 th Edn.Mosby Co. Wong, D.L (2005).Whaley & Wongs Essentials of Pediatric Nursing. 8th edn. Mosby Co. Dr. Elizabeth K E, Nutrition and Child development. Suraj Gupta, Short Text book of pediatrics, Jaypee brothers, New Delhi. Meharben Singh, care of New Born, Sagar Publication. Srivastav R N, IAP Text book of Paediatrics, Jaypee Brothers. Meharban Singh, Paediatrics Emergencies, Sagar Publications. Jane W Ball & Ruth Bindler, Paediatrics Nursing-Caring for Children, Pearson Education. Crawford D, Morris M. Neonatal Nursing. Chapman & Hall. Landon Martha A Q, Curley Smith A B, Patritia A Harman. Critical Care Nursing of Infants and Children. W B Saunders Company. Philadelphia.

53

CLINICAL SPECIALTY-1 MENTAL HEALTH (PSYCHIATRIC) NURSING-1

Placement-I Year
Hours of instruction Theory - 150 Hrs. Practical - 900 Hrs. Total - 1050 Hrs. Resource Persons Psychiatric Nursing Faculty Psychiatrist Psychologist Psychiatric social worker -100 Hrs -25 Hrs -20 Hrs -5 Hrs

Course Description: The course is designed to assist students in developing expertise & in depth understanding in the field of psychiatric nursing. It will help the students to acquire knowledge regarding the psychodynamics of human behaviour, epidemiology, manifestations and treatment modalities of various mental disorders, render holistic care to clients in various settings and to function effectively as a nurse specialist among the interdisciplinary team members. It will help the students to appreciate the latest trends and identify researchable areas in the field of psychiatric nursing and utilize research findings in their practice. Objectives: At the end of the course, the students: 1.Appreciate the trends and issues in the field of Psychiatry and Psychiatric nursing. 2. Explain the dynamics of personality development and human behaviour.

3. Describe the concepts of psychobiology and psychopathology in mental disorders and its implications for psychiatric nursing practice. 4. Demonstrate therapeutic communication skills in all interactions. 5. Establish and maintain therapeutic relationship with individual, groups and families. 6. Apply nursing process in providing holistic care to patients with mental disorders. 7. Carryout counseling and guidance programmes to various types of clients 8. Appreciate the legal and ethical issues pertaining to psychiatric nursing. 9. Demonstrate skills /competencies in nursing management of patients with different mental disorders. 10. Participate in various treatment modalities used for Psychiatric patients. 11. Recognize the role of Psychiatric nurse practitioner as a member of the mental health team.
54

COURSE CONTENT UNIT I TIME (HRS) 5 INTRODUCTION II 10 (Psychiatrist 5) Review of mental health Mental health illness continuum Historical perspectives Current concepts, trends and issues in Psychiatry Mental health services in Kerala, India, and abroad. Scope, issues and challenges in Psychiatric nursing Principles and standards of -Psychiatric nursing practice Multidisciplinary approach and role of the Psychiatric nurse Role of the Psychiatric nurse extended and expanded CONTENT

CONCEPTS OF PSYCHOBIOLOGY AND PSYCHOPATHOLOGY The Nervous System Review of Anatomy The Brain and Limbic System Nervous Tissue Autonomic Nervous System Neurotransmitters Neurons endocrinology

-Circadian rhythm -Pituitary and thyroid glands Genetics Psychopathology Psycho immunology

-Normal Immune Response -Implication for Psychiatric illness III 12 (Psychologist 5) THEORIES OF PERSONALITY DEVELOPMENT AND CONCEPTUAL MODELS OF NURSING PRACTICE Personality an overview Theories of Personality development and relevance to
55

nursing practice -Psychoanalytic theory (Freud) -Interpersonal theory (Sullivan) -Psychosocial theory (Erickson) -Cognitive development theory -Moral development theory -Object relation theory IV 5 V 10 Nursing models Peplau,Roy, Betty Neuman, Jhonson, Roggers. Behavioural model Medical model

STRESS AND ITS MANAGEMENT Concepts of Stress Psychological adaptation to Stress Stress as a biological response Stress as an environmental event Stress as transaction between the individual and the environment Stress management Stress adaptation model

THERAPEUTIC COMMUNICATION AND INTERPERSONAL RELATIONSHIP Review of communication process, factors affecting communication Techniques of therapeutic communication Barriers of communication Therapeutic attitudes Therapeutic Nurse - Client relationship Therapeutic use of self and self awareness Therapeutic impasse and its management Johari window Transactional analysis Assertive communication
56

VI

10

EPIDEMIOLOGY, SYMPTOMATOLOGY AND

(Psychiatrist) CLASSIFICATION Epidemiology of common mental illnesses Clinical manifestations of mental illnesses Classification of mental illness -ICD -DSM -Indian VII 10 (Psychologist 3) VIII 20 (Psychologist 5) IX 10 NURSING PROCESS IN PSYCHIATRIC NURSING Mental health assessment: History, Mental Status Examination Physical and neurological examination Psychometric assessment Investigations, Diagnoses and Differential diagnoses Nursing diagnoses, nursing care plan and evaluation Documentation- computer assisted Critical pathways of care

GUIDANCE AND COUNSELING Counseling ; definition, concepts, types, models Principles and techniques of counseling Role of nurse counselor Guidance- definition, scope, types and techniques Organization of guidance service

THERAPIES IN PSYCHIATRY A. Psychopharmacology

(Psychiatrist 10)

Historical perspectives Anti anxiety agents Anti depressant agents Mood stabilizers Anti psychotics

57

 2 15

Sedatives - Hypnotics Central Nervous System stimulants Other drugs Role of a nurse in psycho pharmacological Therapy

B. Electroconvulsive therapy Historical perspectives Indications Contra indications Mechanisms of action Side effects Risks associated with Electro convulsive therapy Role of nurse in Electro convulsive therapy

C. Seclusion and Restraints

(Psychologist D. Psychosocial therapies 7) Psychotherapy Cognitive therapy Behavioral therapy Relaxation therapy. Positive -negative reinforcement. Biofeedback Guided imagery Group therapy Family therapy Marital therapy Milieu therapy The therapeutic community Occupational therapy Recreational therapy Play therapy Music therapy

(PSW 5)

E. Alternative therapies/Complementary therapies

58

ORGANIC MENTAL DISORDERS Delirium Dementia Organic Amnestic Syndrome Psychopharmacological interventions and nursing management

XI

SUBSTANCE USE DISORDERS Substance use disorders Substance induced disorders Classes of Psychoactive substances Predisposing factors The Dynamics of Substance Related Disorders Codependency Treatment modalities for substance related disorders and nursing management

XII

10

SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS Nature of the disorder Predisposing factors and psychopathology Schizophrenia types -Disorganized Schizophrenia -Catatonic Schizophrenia -Paranoid Schizophrenia -Undifferentiated Schizophrenia -Residual Schizophrenia Other Psychotic Disorders -Schizoaffective disorders -Brief psychotic disorders -Shizophreniform disorders -Psychotic disorder due to a general medical condition. -Substance induced psychotic disorders Treatment and nursing management

XIII

MOOD DISORDERS Historical perspectives

59

 XIV 5 XV 4

Epidemiology and psychopathology The grief response Maladaptive responses to loss Types of mood disorders Depressive disorders Manic disorders Bipolar disorders Treatment and nursing management

ANXIETY DISORDERS Historical perspectives Epidemiology and psychopathology Types Panic disorders Generalized anxiety disorders Phobias Obsessive compulsive disorders Post traumatic stress disorders Anxiety disorders due to general medical condition Substance induced anxiety disorders Treatment modalities Psycho pharmacology and nursing management

ETHICAL AND LEGAL ISSUES IN PSYCHIATRY AND PSYCHIATRIC NURSING Ethical considerations and dilemmas Rights of mentally ill persons Mental health act Legal issues in psychiatry Legal role of nurse

PRACTICAL Total -900 Hours 1 week - 48 Hours STUDENT ACTIVITIES History taking - Weekly one
60

Mental Status Examination Nursing care plan Psychometric assessment Psycho education Drug study Personality assessment Process recording Assisting with EEG, CT, MRI

- Weekly one - Weekly one

-1 -1 -1 -2

Therapies (Participation & Observation) o ECT with patient profile o Group therapy with patient profile o Family therapy with patient profile o Psychotherapy with patient profile o Counseling with patient profile o Milieu therapy/therapeutic Milieu o Occupational therapy o Recreational therapy o Music therapy

Case presentation Case studies Bed side clinic

-4 -2 -3

Project work based on hospital care setting Weightage 50 % 25% 25% Total Practical 100

Method of EvaluationTheory Sessional examinations (3) Seminars Written assignments

Ongoing clinical evaluation Internal practical examination Clinical Assignments Total

40% 25% 35% 100

61

SL NO AREA OF POSTING 1 Acute psychiatric ward 2 Chronic psychiatric ward 3 4 5 6 7 8 Psychiatric emergency OPD Family psychiatry Community mental health Rehabilitation/ occupational therapy/ Half way home/Day care centre De- addiction unit Total

NO. OF WEEKS 4 4 2 2 1 2 2 2 19

References *: Stuart W G and Laraia T M .Principles and Practice of Psychiatric Nursing (Latest edition). Mosby publications. Kneisl C R and Wilson H S. Psychiatric Nursing (Latest edition), Addison wisely nursing publications. Burgess Ann Wolbert .( (Latest edn).. Psychiatric nursing promoting mental health Appleton & Lange. Kaplan H.J & Sadock B .J . Comprehensive Textbook psychiatry (Latest edn). William and Wilkins;Philadelphia . Sadock J.B, Sadock A.V, Kaplan & Sadocks concise Text book of clinical psychiatry, Philadelphia, Lippincott William & Wilkins Company. Townsend M .C. Psychiatric Mental Health Nursing.(Latest edn) Jaypee brothers; New Delhi. Varcarolis E.M. (Latest edn). Foundations of Psychiatric Mental Health Nursing .W.B. Saunders; Philadelphia. Frisch N.C & Frisch L.E (Latest edn). Psychiatric Mental Health Nursing (3 rd edition) Sanat printers Haryana. Banjamin James Sadock & Virgina Sadock, Kalpan Sadock Synopsis of psychiatry. Lippincott. Coleman, James. C, Abnormal Psychology And Modern Life, Latest Edition, Tarap Orvala And Co Pvt. Ltd. Gelder M, Harrison P and Cowen P, Shorter Oxford Textbook of Psychiatry, Latest Edition, Oxford University Press. Krupnick Susan L.W. and Wade Andrew, Psychiatric Care Planning-Now with Clinical Pathways, Latest Edition, Springhouse Corpn, Pennsylvania.
62

 O Brien & Davis, Mental Health & Psychiatric Nursing a caring approach ,Latest Edition, Jones and Bartlett Publishers. Varcarolis Elizabeth. M, Foundations of Psychiatric Mental Health Nursing, Latest Edition, W.B.Saunders Company.Philadelphia. Carson & Arnold, Mental Health Nursing-The Nurse Patient Journey, Latest Edition, W.B.Saunders Company. Philadelphia. Andrew Sims , Symptoms in the Mind: An Introduction to Descriptive Psychopathology, Latest Edition, W. B. Saunders Company. Philadelphia. Barbara Schoen Johnson, Adaptation &Growth- Psychiatric Mental Health Nursing, Latest Edition, Lippincott. WHO.ICD 10 Classification of Mental & Behavioural Disorder Schultz, videbeck C.S Lippincott Manual of Psychiatric Nursing careplans, 7th edition Philadelphia, Lippincott William & Wilkins Company. Johnstone C.E, Ownes, c. et. al, Companion to Psychiatric studies, Philadelphia, Churchill Livingstone. Varcarolis E.M, Halter J.M, Essentials of psychiatric Mental Health Nursing, A communication approach to evidence based care, Philadelphia, Elsevier publication. Videbeck L.S, Psychiatric Mental Health Nursing, Philadelphia, Lippincott William & Wilkins Company. Fontaine Karen Lee. Mental Health Nursing. Pearson Education. Mental Health: An Indian Perspective, 1946-2003. S.P Agarwall (Editor), Directorate General of Health Services, Ministry of Health and Family welfare, New Delhi. J N Vyas, Niraj Ahuja, Post Graduate text book of psychiatry, Jay Pee Publishers Pvt Ltd New delhi. Otong Deborah Antai, Psychiatric Nursing : Biological & Behavioral concepts, Thomson Delmere Learning, Canada.

Note: * Latest Edition

*******************

63

64

CLINICAL SPECIALITY - I OBSTETRIC AND GYNAECOLOGICAL NURSING- 1

Placement: 1st year Hours of Instruction Theory: 150 hours Nursing Faculty 120 hours External Faculty-30 hours Practical: 900 hours Total: 1150 hours. COURSE DESCRIPTION This course is designed to assist students in developing expertise and in depth understanding in the field of Obstetric and Gynaecological Nursing. It will help students to appreciate the client as a holistic individual and develop skill to function as an independent midwifery practitioner. It will further enable the student to function as educator, manager, and researcher in the field of Obstetric and Gynaecological nursing. OBJECTIVES At the end of the course the students will be able to: 1. Examine the trends in the field of midwifery, obstetrics and gynaecology as a specialty. 2. Describe the population dynamics and indicators of maternal and child health. 3. Describe current concepts in genetics and embryology. 4. Identify the role of women in the society 5. Describe the concepts of biophysical, psychological and spiritual aspects of normal pregnancy, labor and puerperium. 6. Provide comprehensive nursing care to women during reproductive period and newborns. 7. Integrate the concepts of family centered nursing care and nursing process approach in obstetric and gynaecological nursing. 8. Identify and analyze the deviations from normal birth process and refer appropriately. 9. Describe the pharmacological agents, their effects during pregnancy, child birth, puerperium, lactation and the role of nurse 10. Counsel adolescents, women and families on issues pertaining to pregnancy, child birth and lactation
65

11. Describe the role of various types of complementary and alternative therapies in obstetric and gynecological nursing. 12. Incorporate evidence based nursing practice and identify the areas of research in the field of obstetric and gynecological nursing. 13. Describe the recent advancement in contraceptive technology and birth control measures. 14. Explain the legal and ethical issues pertaining to obstetric and gynecological nursing. 15. Function as independent midwifery nurse practitioner Course Content Units I Hours 10 Content Introduction Historical and contemporary perspectives Issues of maternal and child health: Age, Gender, Sexuality, sexual health, Psycho- Socio cultural factors Status of women in Indian Society Role of the women in the family & society Women empowerment Preventive obstetrics National health and family welfare programmes related to maternal and child health: health Care delivery system. National Rural Health Mission-Reproductive child health. Theories, models and approaches applied to midwifery practice. Role and scope of midwifery practice: Independent Nurse midwifery practitioner.. Legal and Ethical issues: code of ethics and standards of midwifery practice, standing orders Evidence based midwifery practice Research priorities in Obstetric and Gynaecological nursing. Complementary therapies in obstetric practice.
66

II

20 EF6

Human reproduction Review: Anatomy and physiology of human reproductive system: male and female, Reproductive physiology. Pelvic floor and female pelvis Foetal skull Hormonal cycles, Menarche & Menopause. Endocrinology in relation to reproduction. Embryology Genetics, teratology, prenatal diagnosis and counseling Preconception care, Preparing families for child bearing & child rearing , planned parenthood.

III

25 EF6

Pregnancy Maternal adaptation :- Physiological, Psychosocial Diagnosis of pregnancy Assessment - Maternal and fetal Maternal assessment: History taking, examinationgeneral, physical and obstetrical. Identification of high risk, Foetal assessment clinical parameters. Biochemical- Human estriol, Maternal Serum Alfa Feto protein, Acetyl choline esterase (AchE), Triple Test, Aminocentesis, Cordocentesis. Chorionic villus sampling (CVS). Biophysical -Foetal movement count, Sonography, Cardio tocography, cardio tomography, Non-Stress Test (NST), Contraction stress test (CST), amnioscopy, foetoscopy. Radiological examination of diagnostic tests and nursing Interpretation implications Nursing management of the pregnant women, minor disorders of pregnancy and management, importance of institutional delivery, choice of birth setting,
67

importance and mobilizing of transportation, role of nurse and crisis intervention, identification of high risk pregnancy and referral IV 25 EF3 Normal Labour Essential factors of labour Stages and onset First stage: Physiology of normal labour Use of partograph: Principles, use and critical analysis, evidence based practice. Nursing management

Second stage Physiology and intrapartum monitoring Nursing management Resuscitation, immediate newborn care and initiate breast feeding (Guidelines of National neonatology forum of India) Third stage V 20 EF2 Physiology and nursing management

Fourth stage Observation, critical analysis and nursing management. Psycho-prophylactic measures in labour Evidence based practice

Normal puerperium Review Physiology of puerperium Physiology of lactation, exclusive breast feeding, Baby friendly hospital initiative (BFHI) Assessment of postnatal women. Minor discomforts and complications of puerperium Management of mothers during puerperium:

Psychosocial adaptation Role of nurse midwifery practitioner

68

VI

20 EF1

Normal Newborn Review Physiology and characteristics of normal newborn Physical and behavioural assessment of newborn Essential newborn care Identification of high risk newborn & referral. Parenting process

VII

10 EF4

Pharmaco-dynamics in obstetrics Drugs used in pregnancy, labour, post partum and newborn Calculation of drug dose and administration Anesthesia and analgesia in obstetrics Roles and responsibilities of midwifery nurse

practitioner Standing orders and protocols and use of selected life saving drugs and interventions of obstetric emergencies approved by the MOHFW VIII 5 EF3 Abortion Types, causes Legislations, responsibility Abortion procedures Nursing Management IX 5 EF3 Infertility Review Male and female infertility Primary and secondary causes Diagnostic procedures Counseling: ethical and legal aspects of assisted reproductive technology (ART) Recent advancement in infertility management Adoption procedures Role of nurse in infertility management Clinical rights and professional

69

10 EF2

Family Welfare Services Review Population dynamics Demographic trends: vital statistics, calculation of indicators especially maternal and neonatal mortality rates and problems and other health problems. Recent advancement in contraceptive technology Role of Nurses in family welfare programmes in all settings. Family life education. Evidence based practice. Information, Education and Communication (IEC) Management information and evaluation system (MIES) Teaching and supervision of health team members

Practical Experience Total = 900 Hours 1 week = 48 hours

Sl.No 1 2 3 4 5 6 Antenatal wards Labour Room Postnatal Ward

Dept/ unit

Weeks 5 5 4 1 2 2 19

Family Planning Clinics& OPDs PHC/Rural Maternity settings Maternity OT Total

70

Procedures to be Observed Diagnostic investigations: amniocentesis, cordocentesis, chorionic villus sampling, ultrasonogram. Infertility management: artificial reproduction: artificial insemination, invitro fertilization and related procedures.

Procedures to be assisted Medical termination of pregnancy Male and female sterilization Major and minor operations.

Procedures to be performed Antenatal assessment Postnatal assessment Assessment during labour -Use of partograph : 20 Per vaginal examination : 20 : 20 : 20

Conduct of normal delivery : 20 Episiotomy and suturing :10 (Copper-T)

Insertion of intra uterine devices

Others Identification of high risk women and referral Health education to women and their families Motivation of couples for Planned Parenthood.

Observation visit Infertility centre, 24/7 FRUs Assignments Nursing care study Antenatal, intranatal, postnatal, neonatal Planned health education Clinical teaching Case Presentation 4 5 15 5
71

Preparation of protocol of management in obstetrical nursing. (AN, IN, PN, NN) Log Book 4

Evaluation Methods Assignments Theory & Practical Exam Ongoing evaluation

Theory Tests (3) Assignments Seminars Total

Weightage 50% 25% 25% 100%

Practical Ongoing evaluation Clinical assignment Int. Practical exam Total

Weightage 50% 25% 25% 100%

References *: Lowdermilk, Perry, Bobak. Maternity Nursing. Mosby, Inc. Sharon, Emily & Trula Mayers. Foundations of Maternal & Newborn Nursing. W.B.Saunders, Philadelphia. Reeder, Martin, Koniak-Griffin .Maternity Nursing. Lippincott. Philadelphia. Helen Varney, Jan M Kriebs, Cardyc L Gesa, Midwifery. Jones & Bartlett publisher. Susan L Ward and Sheltar M Histely, Maternal Child Nursing Care Optimizing outcomes for Mothers, Children and families-Jay Pee Brothers, New Delhi. Cunnigham, Mac Donald, Gand, Leveno, Gilstrap, Hankins & Clark. Williams Obstetrics. Prentice Hall International, U.S.A. Adele Pillitteri. Maternal & Child Health Nursing. Lippicott, Philadelphia. Ratnam, Bhasker Rao, Arulkumaran. Obstetrics & Gynaecology for Post graduates. Orient Longman Ltd, Chennai. Hacker, Moore. Essentials of Obstetrics & Gynaecology. Harcourt Brace &Company, Asia PTE Ltd. Inderbir, Singh. Human Embryology. Mac Millan India Ltd.
72

Mandakini Parihar, Aswini Bhalerao Gandhi Contraception Past, Present and Future, F OGSI JP 2006, New Delhi. Gita Ganguly Mukerjee, Nareure, Malhotra Medicological Aspects in Obstetrics and Gynaecology-FOGSI, JP 2008, New Delhi. Pankaj Desai, Narendre Mehare, Durushel, Principles and Practice of Obstetrics & Gynaecology for Post Graduates 3rd ed, JP, New Delhi Womens Health and Guide to Health Promotion and disorders management, Lippincott, Philadelphia. Arias, Shrish N Dutta 2008, 3rd edn, Practical Guide to High risk Pregnancy Delivery, ELSEVIER. Illyesa T Foster and Jon Lesser. Professional Ethics in Midwifery Practice . 2010. Jones and Bartlett. New Delhi. Mukerjee Medicolegal Aspects in Obstetrics and Gynaecology Deka An Introduction to genetics & Fetal Medicine. Jaypee Brothers. Dutta. Drugs in Pregnancy How Safe?. Jaypee Brothers.

Note: * Latest Edition

73

CLINICAL SPECIALTY 1 COMMUNITY HEALTH NURSING 1

PlacementI Year Hours of instruction Theory - 150 hours External - 20 Hours Internal -130Hours Practical - 900 hours Total - 1050 hours Course Description: This course is designed to assist students in developing expertise and indepth understanding in the field of community health. It will enable the students to acquire knowledge regarding concepts, principles, methods and approaches in community health nursing. It will help the students to learn about epidemiology, environmental health, population dynamic, family health care. Objectives: At the end of the course, the students will be able to:

1. Review the history and development in the field of community health and community health nursing 2. Analyze the role of individuals and families in promoting health of the community 3. Perform physical, developmental and nutritional assessment of individuals, families and groups 4. Apply the concepts of promotive, preventive, curative and rehabilitative aspects of health while providing care to the members of the community 5. Apply nursing process approach while providing care to individuals, families, groups and community. 6. Integrate the concepts of family centered nursing approach while providing care to the community. 7. Apply concepts and principles of epidemiology in the practice of community health nursing 8. Recognize and participate in the management of emergencies, epidemics and disasters 9. Utilize the concept of demography and its application in public health
74

10. Appreciate legal and ethical issues pertaining to community health nursing care 11. Conduct community health nursing care projects 12. Participate in planning, implementation and evaluation of different national health and family welfare programmes at local, state and national level. 13. Participate effectively as a member of community health team 14. Coordinate and collaborate with various agencies operating in the community by using inter sectoral approach 15. Teach community health nursing to undergraduates, in-service nurses and the community health workers COURSE CONTENT: Unit I Hours 10 II 10 Content Introduction Historical development of community health and community health nursing in the world, India Current status, trends, challenges and scope of community health nursing Philosophy, aims, objectives, concepts, principles and functions of community health nursing Community health nursing theories and models Role of community health nurse at various settings

Community health nursing process Community identification-concept, methods

definition,

purpose,

Group dynamics and community participation Community health nursing process-definition, assessment, community diagnosis Planning, implementation and evaluation

III

15

Family health care Concept of family, types Functions of family in health and disease Family developmental cycle Developmental tasks of the family
75

 IV 30 (Ext-20 Hrs)

Family as a basic unit of health service Theoretical framework for family health care Tools for family assessment Family budgetting Family nursing process Home visit Standing orders Techniques of family nurse contact

Epidemiology History, definition and aims of epidemiology Measurements in epidemiology Epidemiologic methods Dynamics of disease transmission Levels of prevention Epidemiology of communicable diseases Epidemiology of non communicable diseases Emerging and re-emerging disease epidemics

10

Community Nutrition Nutritional problems in community health Assessment of nutritional status Nutritional surveillance Community nutrition programmes Meal planning for the family

VI

15

Maternal and child health services Maternal health care services Antenatal, intranatal, postnatal services Child health services Integrated management of neonatal and childhood illnesses
76

VII

15

Population Dynamics and Control Demography Transition and theories of population growth National population policy National population programmes Population Control Methods of family planning Research, census, National family health survey Vital statistics

VIII

10

Health Education Changing perspectives: IEC/BCC definition, principles and strategies Communication skills Information and evaluation system Information Technology in health education Tele medicine and Tele Nursing Mass media Folk media

IX

10

Public Health Laws: Ethical principles in community health nursing Legal issues in community health nursing

25

Environmental Health Changes in ecosystem Impact of ecological changes on health Global Warming, green house effect, deforestation Medical entomology Disaster Management

77

Practical Experience Total = 900 Hours 1 week = 48 hours Sl. No Dept/Unit No. of weeks 1 Preventive clinic, Infectious disease unit, family planning unit, Paediatrics & Neonatology Antenatal & Postnatal unit, Labour room 2 3 4 Primary health centre, Community health centre Urban centre Selected community Total Student Activities Identification of community leaders and resource persons (community mapping ) Identification of a selected community (Health Survey, identification of resources) Community health nursing process individual, family, community and special groups Planning, implementing need based health programs for the community Counseling Health education campaign, exhibition, folk media, preparation of IEC materials Organizing and participating in special clinics/ camps and national health and welfare programs Organize at least one health and family welfare projectmela/fair/exhibition Estimation of vital health statistics exercise Drill for disaster preparedness Health assessment adults, elderly, antenatal & postnatal women, children Nutrition Exercise on nutritional assessment dietary planning, demonstration and education for various age groups Filling up of records, reports and registers maintained at sub centre/PHC/CHC Assist women in self breast examination
78

6 weeks

6 weeks 2 weeks 5 weeks 19 weeks

Conduct antenatal examination Conduct vaginal examination Conduct deliveries Postnatal visits Perform Episiotomy and suturing Prepare Pap smear Conduct insertion/removal of IUCD Assist laparoscopic sterilization, vasectomy Malarial slide preparation Observation visits/field visits to ART centre, RNTCP unit Maintain log book for all practical activities Method of Evaluation Theory Weightage 50 % 25% 25% 100%

Sessional examinations (3) Seminars Written assignments Total Practical Ongoing clinical evaluation Internal practical examination Clinical Assignments Total

30% 25% 45% 100%

References *: Kamalam.S. Essentials of Community Health Nursing Practices. 2nd edn. Jaypee Brothers. New Delhi 2005. Clemen Stone S, Eigsti D G, M C Guire S L. Comprehension Community Health Nurisng. 4th edn. Mosby. Caludia M Smith, Frances A Maurer. Community Health Nursing, Theory and Practice. W B Saunders. Philadelphia 1996. Stanhope Marcia. Community and Public Health Nursing-Population centered health. 8th edn. Mosby Publication 2009. Allender, Spardely, Barbara Watton. Commmunity Health Nursing concepts and
79

Practice. Mosby. Rahim, A Principles and practice of Community Medicine, New Delhi,Jaypee Brothers 2006. Macewen-Community based Nursing 2009.Elsevier. Leake-Community Public Health Nursing. Mosby 2009. Elsevier. Ruth B Freeman Textbook of Primary Health Nursing Practices. G M Dhar, I Robbani-Foundations of Community Medicine. Elsevier. Mary A Nies, Melame McEwen. Community/Public Health Nursing promoting the Health of Population. W B Saunders. Clark M, J. Nursing in the Community, Appleton and Lange, Connecticut, Latest Edn Clemen Stone S, Eigsti D, G. McGuire S, L. Comprehensive Family and Community Health Nursing, Mosby, Latest Edn. Cookfair J, M. Nursing Process and Practice in the Community, Mosby, Latest Edn. Dharr G, M.Robbani I, Foundations of Community Medicine Elsevier, Latest Edn. Rahim A. Principles and practices of community medicine, Jaypee Brothers medical Publishers. Suryakantha.A.H. Community Medicine with recent advances , Jaypee Brothers medical Publishers. Gulani K, K. Community Health Nursing:Principles and practices. Latest Edn. Kerr J, Community Health Promotion BAILLIERE Tindall, Latest Edn. Loudan, N. Glasier A, Gebbie A Hand book of Family Planning Reproductive Health Care, Churchill Livingstone. Latest Edn Stanhope M. Lancaster J. Community Health Nursing, The C V Mosby Company D.C, Latest Edn. TNAI. A Community Health Nursing Manual

Note: * Latest Edition *********

80

NURSING MANAGEMENT
Placement: II Year Hours of Instruction Theory :150 Hours Nurse Specialist :100 Hours External :50 Hours Practical :200 Hours Total : 350 Hours Course Description This course is designed to assist students to develop a broad understanding of principles, concepts, trends and issues related to nursing management. Further, it would provide opportunity to students to understand, appreciate and acquire skills in planning, supervision and management of nursing services at different levels to provide quality nursing services. Objectives At the end of the course, students will be able to: 1. Formulate the philosophy and objectives of the health care institutions at various levels. 2. 3. Identify trends and issues in nursing Discuss the public administration, health care administration and nursing administration 4. 5. Describe the principles of administration applied to nursing Explain the organization of health and nursing services at the various levels/institutions. 6. Discuss the planning, supervision and management of nursing workforce for various health care settings. 7. Discuss various collaborative models between nursing education and nursing service to improve the quality of nursing care 8. 9. Identify and analyze legal and ethical issues in nursing administration Describe the process of quality assurance in nursing services.

10. Demonstrate leadership in nursing at various levels. 11. Organize staff development programme.

81

COURSE CONTENT Unit I Theory 10 *EF5 Introduction Philosophy, purpose, elements, Principles, Concepts of Management-(Review). Indian Constitution, Indian Administrative system health care delivery system: National, State and Local Organisation and functions of nursing services and education at National, State, District and institutions: Hospital and Community Planning process: Five year plans, Various Committee Reports on health, State and National Health policies, national population policy, national policy on AYUSH and plans II 10 EF5 Management Functions of administration Planning and control Co-ordination and delegation Decision making decentralization basic goals of decentralization. Concept of management Nursing management Concept, types, principles and techniques Vision and Mission Statements Philosophy, aims and objective Current trends and issues in Nursing Administration Theories and models Application to nursing service and education III 15 EF5 Planning Planning process: Concept, Principles, Institutional policies Mission, philosophy, objectives, Strategic planning Operational plans Management plans Programme evaluation and review technique(PERT), Gantt chart, Management by objectives(MBO) Planning new venture Planning for change
82

Content

Innovations in nursing Application to nursing service and education IV 15 EF5 Organisation Concept , principles, objectives, Types and theories, Minimum requirements for organisation, Developing an organizational Structure, levels, organizational Effectiveness and organizational, Climate, Organising nursing services and patient care: Methods of patient assignmentAdvantages and disadvantages, primary nursing care, Planning and Organising: hospital, unit and ancillary services(specifically central sterile supply department, laundry, kitchen, laboratory services, emergency etc) Disaster management: plan, resources, drill, etc Application to nursing service and education V 15 EF5 Human Resource for health Staffing Philosophy Norms: Staff inspection unit(SIU), Bajaj Committee, High power committee, Indian nursing council (INC) Estimation of nursing staff requirement- activity analysis Various research studies Recruitment: credentialing, selection, placement, promotion Retention Personnel policies Termination Staff development programme Duties and responsibilities of various category of nursing personnel Applications to nursing service and education

83

VI

15 EF5

Directing Roles and functions Motivation: Intrinsic, extrinsic, Creating motivating climate, Motivational theories Communication : process, types, strategies, Interpersonal communication, channels, barriers, problems, Confidentiality, Public relations Delegation; common delegation errors Managing conflict: process, management, negotiation, consensus Collective bargaining: health care labour laws, unions, professional associations, role of nurse manager Occupational health and safety Application to nursing service and education

VII

10

Material management Concepts, principles and procedures Planning and procurement procedures : Specifications ABC analysis, VED (very important and essential daily use) analysis Planning equipments and supplies for nursing care: unit and hospital Inventory control Condemnation Application to nursing service and education

VIII

15 EF5

Controlling Quality assurance Continuous Quality Improvement Standards Models Nursing audit Performance appraisal: Tools, confidential reports, formats, Management, interviews Supervision and management: concepts and principles Discipline: service rules, self discipline, constructive versus destructive discipline, problem employees, disciplinary proceedingsenquiry etc Self evaluation or peer evaluation, patient satisfaction, utilization review
84

Application to nursing service and education IX 15 EF5 Fiscal planning Steps Plan and non-plan, zero budgeting, mid-term appraisal, capital and revenue Budget estimate, revised estimate, performance budget Audit Cost effectiveness Cost accounting Critical pathways Health care reforms Health economics Health insurance Budgeting for various units and levels Application to nursing service and education X 10 EF5 Nursing informatics Trends General purpose Use of computers in hospital and community Patient record system Nursing records and reports Management information and evaluation system (MIES) E- nursing, Telemedicine, telenursing Electronic medical records XI 10 Leadership Concepts, Types, Theories Styles Manager behaviour Leader behaviour Effective leader: Characteristics, skills Group dynamics Power and politics lobbying Critical thinking and decision making
85

Stress management Applications to nursing service and education XII 10 EF5 Legal and ethical issues Laws and ethics Ethical committee Code of ethics and professional conduct Legal system: Types of law, tort law, and liabilities Legal issues in nursing: negligence, malpractice, invasion of privacy, defamation of character Patient care issues, management issues, employment issues Medico legal issues Nursing regulatory mechanisms: licensure, renewal, accreditation Patients rights, Consumer protection act(CPA) Rights of special groups: children, women, HIV, handicap, ageing Professional responsibility and accountability Infection control Standard safety measures *EF- External Faculty PRACTICALS 1. 2. 3. 4. 5. 6. Prepare prototype personal files for staff nurses, faculty and cumulative records Preparation of budget estimate, revised estimate and performance budget Plan and conduct staff development programme Preparation of Organization Chart Developing nursing standards/protocols for various units Design a layout plan for specialty units /hospital, community and educational institutions 7. 8. 9. Preparation of job description of various categories of nursing personnel Prepare a list of equipments and supplies for specialty units Assess and prepare staffing requirement for hospitals, community and educational institutions 10. Plan of action for recruitment process 11. Prepare a vision and mission statement for hospital, community and educational institutions 12. Prepare a plan of action for performance appraisal
86

13. Identify the problems of the specialty units and develop plan of action by using problem solving approach 14. Plan a duty roster for specialty units/hospital, community and educational institutions 15. Prepare: anecdotes, incident reports, day and night reports, handing and taking over reports, enquiry reports, nurses notes, official letters, curriculum vitae, presentations etc. 16. Prepare a plan for disaster management 17. Observation visit to a multispecialty teaching hospital and College and School of Nursing Methods of Teaching Lecture cum discussion Seminar / Presentations Workshop Methods of evaluation Tests Presentation Written assignments

Internal Assessment Techniques Tests Assignments Seminar/presentations

NO 3

Weightage (%) 50 25 25

------------------------------------------------------------------------------Total Assignments Theory Statement of Philosophy, mission, vision and objective of a hospital. Prepare Job Descriptions of Various Categories of Nursing Personnel. Prepare Budget estimate for Nursing Department. Compute Staffing Requirement of hospital (Yearly, Monthly, Weekly.) Performance Appraisal Format for Nursing Staff.
87

100%

Practical Nursing Rounds Clinical Teaching of Students Staff Development Programme Nursing Care Conference Clinical Posting Various Wards/ICUs of Hospital. - 4 Weeks 5 1 1 1

Office of Nursing Superintendent / Nursing Officer- 1 week

Reference *: Bessei L.Marquise Carol J.Huston ,Leadership and Management functions in Nursing-Theory & application ,2nd Edition, Lippincott, Philadelphia. Stephen P.Robbins and Mary Coultar, Management,5th Edition,Printice Hall ,Inc, New jersey. AnnMarriner-Tomey ,Guide to Nursing Management,4th Edition, Moseby Yearbook, Philadelphia. Kochuthresiamma,T(2001) Nursing Management and Administration, Medical works. Heinz Weihrich and Harold Koontz ,Management A Global perspective,10th Edition, Mc Grawhill International Edition, Singapore. ElsVan Ooijen,Clinical Supervision,2000,Churchill Livingston,London. Joseph L Massie,Essentials of Management,4th Edition,Printice Hall ,New Delhi. Sakti Gupta,Sunil Kant,Hospital and Health Care administration-Appraisal & Referral Treatise,1998,Jaypee Brothers,New Delhi. Graham Rumbold,Ethics in Nursing Practice,3rd Edition,Bailliere Tindall,New York. Roberta Strassle Abruzzese,Nursing Staff Development-Strategies for Success,2nd Edition, Mosby Publication,London. Karen.j.Kelly-Thomas,Clinical and Nursing staff Development-Current Competence,Future Focus, 2nd Edition, Lippincott,New York. Jennifer Mackenzie,Ward Management in Practice,1998, Churchill Livingston,London. Dharma Vira Aggarwala, Manpower- planning, Selection ,Training and Development, Latest Edition, Deep Publication, New Delhi.
88

 Jennie Wilson, Infection Control in Clinical Practice,3rd Edition,Billiere Tindal London. Sayed Amin Tabish ,Hospitals and Nursing Homes Planning Organizations and Management,2005, Jaypee Brothers ,New Delhi. G.N.Prabhakara,Policies and Programmes of Health in India,2005, Jaypee Brothers ,New Delhi. June Girvin,Leadership and Nursing ,Latest Edition,Mc Millan Co,London. Lynda A.Bernhard,Michelle Walsh,Ledership-The Key to the Professionalisation of Nursing,2nd Edition,CV Mosby Co,Philadephia. Huber D L (2006) Leadership & Nursing care Management Philadelphia, ELSEVIER. Marrelli T m (2004) The Nurse Managers Survival Guide, st. Louis, Mosby. Yoder-wire P S (2007) Leading & Mangers in Nursing St. Louis, Mosby. Partons Jones R A (2008) Nurisng Leadership and management, New Delhi, Jaypee. Sakharkar B M (2009) Principles of Hospital Administration & Planning, New Delhi, Jaypee. Marquis B L & Huston C J (2009) Leadership roles & Management functions in Nursing, New Delhi, Lippincott. Finkler SA & Mc High (2008) Budgeting concepts for Nurse Managers, St. Louis, SAUNDERS. Yoder-wire P S & Kowalski K E (2006) Beyond Leading and Managing Nursing Administration for me future, St. Louis, MOSBY. Gupta C B (1994) Management & Organization New Delhi, Sultan Chand & Sons. Prasad L M, Principles & Practice of Management, New Delhi, Sultanchand & Sons Educational Publishers. Rouscl L(2010), Management and Leadership for Nurse Administrators, New Delhi, Jones and Bartlett Publishers. Finkelman A, Kenner C(2010), Professional Nursing concepts-Competency for quality leadership, USA, Jones and Bartlett Publishers. Klainberg M, Dirschel K M(2010), Todays Nursing Leader, managing succeeding and excelling, USA, Jones and Bartlett Publishers.

89

CLINICAL SPECIALITY II MEDICAL SURGICAL NURSING-II

SUB SPECIALITY CARDIO VASCULAR AND THORACIC NURSING
Placement : II year Hours of Instruction Theory : 150 hours. Nursing Faculty:-125 hrs External Faculty:-25 hrs Practical : 1450 hours. Total : 1600 hours. Course Description This course is designed to assist students in developing expertise and in-depth understanding in the field of cardiovascular and thoracic nursing. It will help students to develop advanced skills for nursing intervention in various cardio medical and surgical conditions. It will enable the student to function as Cardio vascular and Thoracic Nurse practitioner/specialist. It will further enable the student to function as educator, manager and researcher in the field of cardio vascular and thoracic nursing.

Objectives At the end of the course the students will be able to: 1. 2. Appreciate trends and issues related to cardio vascular and thoracic Nursing. Describe the epidemiology, etiology, patho-physiology and diagnostic assessment of cardio vascular and thoracic conditions 3. Participate in national health programs for health promotion, prevention and rehabilitation of patients with cardio vascular and thoracic conditions 4. 5. 6. Perform physical, psychosocial & spiritual assessment Assist in various diagnostic, therapeutic and surgical procedures Apply nursing process in providing comprehensive care to patients with cardio vascular and thoracic conditions 7. Demonstrate advance skills/competence in managing patients with cardio vascular and thoracic conditions including Advance Cardiac Life Support.
90

8.

Describe the various drugs used in cardio vascular and thoracic conditions and nurses responsibility

9.

Demonstrate skill in handling various equipments/gadgets used for critical care of cardio vascular and thoracic patients

10. Appreciate team work & coordinate activities related to patient care. 11. Practice infection control measures. 12. Identify emergencies and complications & take appropriate measures 13. Discuss the legal and ethical issues in cardio vascular and thoracic nursing 14. Assist patients and their family to cope with emotional distress, grief, anxiety and spiritual needs. 15. Appreciate the role of alternative system of medicine in care of patient 16. Incorporate evidence based nursing practice and identify the areas of research in the field of cardio vascular and thoracic nursing 17. Identify the sources of stress and manage burnout syndrome among health care providers. 18. Teach and supervise nurses and allied health workers. 19. Design a layout of ICCU and ICTU and develop standards for cardio vascular and thoracic nursing practice. CONTENT OUTLINE Unit 1 Hours 5 Introduction: Historical development, trends and issues in the field of cardiology. Cardio vascular and thoracic conditions major health problem. Concepts, principles and nursing perspectives Ethical and legal issues Evidence based nursing and its application in cardio vascular and thoracic nursing( to be incorporated in all the units) II 5 Epidemiology Risk factors: hereditary, psycho social factors, hypertension, smoking, obesity, diabetes mellitus etc Health promotion, disease prevention, Life style modification National health programs related to cardio vascular and thoracic
91

Content

conditions III 5 Alternate system of medicine Complementary therapies

Review of anatomy and physiology of cardio vascular and respiratory system Review of anatomy and physiology of heart, lung, thoracic cavity and blood vessels. Embryology of heart and lung. Coronary circulation, Foetal Circulation Hemodynamics and electro physiology of heart. Bio-chemistry of blood in relation to cardio pulmonary function

IV

20 EF5

Assessment and Diagnostic Measures: History taking Physical assessment Heart rate variability: Mechanisms , measurements, pattern, factors, impact of interventions on HRV Diagnostic tests Hemodynamic monitoring: Technical aspects, monitoring, functional hemodynamic indices, ventricular function indices, output measurements (Arterial and swan Ganz monitoring). Blood gases and its significance, oxygen supply and demand Radiologic examination of the chest: interpretation, chest film findings Electro cardiography(ECG) : electrical conduction through the heart, basic electrocardiography, 12 lead electrocardiogram, axis determination - ECG changes in: intraventricular conduction abnormalities- Arrhythmias, ischemia, injury and infarction, atrial and ventricular enlargement, electrolyte imbalance, Echocardiography: technical aspects, special techniques, echocardiography of cardiac structures in health and disease, newer techniques Nuclear and other imaging studies of the heart: Magnetic Resonance Imaging. Cardio electrophysiology procedures: diagnostic studies, interventional and catheter ablation, nursing care
92

Exercise testing: indications and objectives, safety and personnel, pretest considerations, selection, interpretation, test termination, recovery period

Cardiac catheterization: indications, contraindications, patient preparation, procedure, interpretation of data Pulmonary function test: Bronchoscopy and graphies Interpretation of diagnostic measures Nurses role in diagnostic tests

Laboratory tests using blood: Blood specimen collection, Cardiac markers, Blood lipids, Hematologic studies, Blood cultures, Coagulation studies, Arterial blood gases, Blood Chemistries, cardiac enzyme studies, Serum Concentration of Selected drugs. Interpretation and role of nurse. V 25 EF4 Cardiac disorders and nursing management: Etiology, clinical manifestations, diagnosis, prognosis, related pathophysiology, newer treatment modalities and nursing management of: Hypertension Coronary Artery Disease. Angina of various types. Cardiomegaly Myocardial Infarction, Congestive cardiac failure Heart Failure, Pulmonary Edema, Shock. Rheumatic heart disease and other Valvular Diseases Inflammatory Heart Diseases, Infective Endocarditis, Myocarditis, Pericarditis. Cardiomyopathy, dilated, restrictive, hypertrophic. Arrhythmias, heart block Associated illnesses VI 10 EF3 Altered pulmonary conditions Etiology, clinical manifestations, diagnosis, prognosis, related pathophysiology, treatment modalities and nursing management of: Bronchitis Bronchial asthma Bronchiectasis
93

 Pneumonias Lung abscess, lung tumour Pulmonary tuberculosis, fibrosis, pneumoconiosis etc Pleuritis, effusion Pneumo, haemo and pyothorax Interstitial Lung Disease Cystic fibrosis Acute and Chronic obstructive pulmonary disease (conditions leading to) Cor pulmonale Acute respiratory failure Adult respiratory distress syndrome Pulmonary embolism Pulmonary Hypertension VII 10 EF3 Vascular disorders and nursing management Etiology, clinical manifestations, diagnosis, prognosis, related pathophysiology, treatment modalities and nursing management of: Disorders of arteries Disorders of the aorta Aortic Aneurysms, Aortic dissection Raynauds phenomenon Peripheral arterial disease of the lower extremities Venous thrombosis Varicose veins Chronic venous insufficiency and venous leg ulcers Pulmonary embolism

VIII

10 EF3

Cardio thoracic emergency interventions CPR- BLS and ALS Use of ventilator, defibrillator , pacemaker Post resuscitation care. Care of the critically ill patients Psychosocial and spiritual aspects of care Stress management; ICU psychosis
94

Role of nurse

IX

10 EF3

Nursing care of a patient with obstructive airway Assessment Use of artificial airway Endotracheal intubation, tracheostomy and its care Complication, minimum cuff leak, securing tubes

10 EF4

Oxygen delivery systems. Nasal Cannula Oxygen mask, Venturi mask Partial rebreathing bag Bi-PAP and C-PAP masks Uses, advantages, disadvantages, nursing implications of each.

XI

10

Mechanical Ventilation Principles of mechanical ventilation Types of mechanical ventilation and ventilators. Modes of ventilation, advantage, disadvantage, complications. PEEP therapy, indications, physiology, and complications. Weaning off the ventilator. Nursing assessment and interventions of ventilated patient

XII

20

Congenital Heart Diseases Etiology, clinical manifestations, diagnois, prognosis, related pathophysiology, treatment modalities and nursing management of: Embryological development of heart. Classification cyanotic and acyanotic heart disease. Tetralogy of Fallots. Atrial Septal Defect, Ventricular Septal Defect., Eisenmengers complex. Patent ductus arteriosus, AP window Truncus Arteriosus. Transposition of great arteries. Total Anomaly of Pulmonary Venous Connection. Pulmonary stenosis, atresia.
95

 Coarctation of aorta. Ebsteins anomaly Double outlet right ventricle, Single ventricle, Hypoplastic left heart syndrome.

XIII

Pharmacology Review Pharmacokinetics Analgesics/Anti inflammatory agents Antibiotics, antiseptics Drug reaction & toxicity Drugs used in cardiac emergencies Blood and blood components Antithrombolytic agents Inotropic agents Beta-blocking agents Calcium channel blockers. Vaso constrictors Vaso dilators ACE inhibitors. Anticoagulents Antiarrhythmic drugs. Anti hypertensives Diuretics Sedatives and tranquilizers. Digitalis. Antilipemics Principles of drug administration, role and responsibilities of nurses and care of drugs

XIV

Nursing Care of patient undergoing cardio thoracic surgery Indications, selection of patient Preoperative assessment and preparation; counseling. Intra-operative care: Principles of open heart surgery, equipment,
96

anesthesia, cardiopulmonary by pass. Surgical procedures for Coronary Artery Bypass Grafting, recent advances and types of grafts, Valve replacement or reconstruction, cardiac transplant, Palliative surgery and different Stents, vascular surgery, other recent advances. Thoracic surgery: lobectomy, pneumonectomy, tumour excision etc Immediate postoperative care : assessment, post operative problems and interventions : Bleeding, Cardiac tamponade, Low cardiac output, Infarction, Pericardial effusion, Pleural effusion, Pneumothorax, Haemothorax, Coagulopathy, Thermal imbalance, Inadequate ventilation/perfusion, Neurological problems, renal problems, Psychological problems. Chest physiotherapy Nursing interventions- life style modification, complementary therapy/alternative systems of medicine. Intermediate and late post operative care after CABG, valve surgery,others. Follow up care Cardiac rehabilitation Process Physical evaluation Life style modification Physical conditioning for cardiovascular efficiency through exercise Counseling Follow up care Intensive Coronary Care Unit/intensive cardio thoracic unit: Quality assurance Standards, Protocols, Policies, Procedures Infection control; Standard safety measures Nursing audit Design of ICCU/ICTU Staffing; cardiac team Burn out syndrome Nurses role in the management of I.C.C.U and ICTU.
97

Mobile coronary care unit. Planning inservice educational programme and teaching Practicals Total 1450 Hours 1 Weeks = 48 Hours

SL. No

Dept/ Unit

No.of weeks

1.

Cardio thoracic- Medical -Surgical

4 4 4 2 5 4 4 2 1 30

2 3 4 5 6 7 8

OT ( cardiac & Thoracic) Diagnostic Lab including cath Lab ICCU ICU CCU Paediatric Intensive Care OPD Total

Internal Assessment Theory weightage Sessional exams -3 Written assignments 50% 25% 25% Seminars/Presentations Total Essential Nursing Skills Procedures to be observed 1. Echo cardiogram 2. Ultrasound 3. Monitoring JVP , CVP 4. CT SCAN 5. MRI
98

Practical weightage Ongoing assessment Clinical assignments Internal examination

50% 30% 20%

100%

TOTAL

100%

6. PET SCAN 7. Angiography 8. Cardiac catheterization 9. Angioplasty 10. Various Surgeries 11. Any other

I. Procedures to be assisted 1. Arterial blood gas analysis 2. Thoracentesis 3. Lung biopsy 4. Computer assisted tomography (CAT Scan) 5. M.R.I. 6. Pulmonary angiography 7. Bronchoscopy 8. Pulmonary function test 9. ET tube insertion 10. Tracheostomy tube insertion 11. Cardiac catheterization 12. Angiogram 13. Defibrillation 14. Treadmill test 15. Echo cardiography 16. Doppler ultrasound 17. Cardiac surgery 18. Insertion of chest tube 19. CVP Monitoring 20. Measuring pulmonary artery pressure by Swan-Ganz Catheter 21. Cardiac Pacing

II. Procedures to be Performed 1. Preparation of assessment tool for CT client (Cardiac, thoracic and vascular). 2. ECG Recording, Reading, Identification of abnormalities

99

3. Oxygen therapy Cylinder, central supply, Catheter, nasal canula, mask, tent, through ET and tracheostomy tube, manual resuscitation bag. 4. Mechanical ventilation 5. Spirometer 6. Tuberculin skin test 7. Aerosol therapy 8. Nebulizer therapy 9. Water seal drainage 10. Chest physiotherapy including Breathing Exercises, Coughing Exercises, Percussion &Vibration 11. Suctioning Oropharyngeal, nasotracheal, Endotracheal 12. Through tracheostomy tube 13. Artificial airway cuff maintenance 14. CPR 15. Care of client on ventilator 16. Identification of different Arrhythmias, abnormal pulses, respirations, B.P. Variation, Heart sounds, Breath sounds 17. Pulse oxymetry 18. Introduction of intracath 19. Bolus I.V. Injection 20. Life line 21. Maintenance of Heplock 22. Subcutaneous Injection of Heparin 23. Obtaining leg measurements to detect early swelling in thrombophlebetis 24. Identification of Homans sign 25. Buergen Allen exercises

REFERENCES * : Hatchett,Richard; Thompson, David Cardiac Nursing ,a comprehensive guide Churchill Livingstone Susal L Woods, Erika S Frorlicher Sandra A Motzer Elizabath V Bridges Cardiac Nursing 2nd Edn 1989,Philadelphia, Lippincott Company. Cathy E Guzetta and Barbara Montgomery Dossy, Cardio Vascular Nursing Holistic Practice, Mosby.
100

 Betsy A Finkelmier, Cardio Thoracic Nursing 1995. Darovic ,Gloria Oblouk Hemodynamic monitoring W.B.Saunders , 3rd edn. Libby etal. Braunwalds heart disease8th edn. Elsevier Smeltzer ,Suzanne.C Brunner and Suddarths Text book of Medical surgical Nursing.11th edn :Lippincott. Monahaa,Frances Donovan.phipps Medical Surgical Nursing.8th edn.Mosby. Ignatavicius ,Donna D.Medical-Surgical Nursing5th edn.Elsevier. Goldman,Ausiello-cecils Textbook of Medicine23rd edn Elsevier. John M Field,Micheal J Breske, Amal Mattu, Textbook of Emergency Cardiovascular care and CPR. Cardiac Nursing Companion to Braunwalds, Debra K Moser, Barbara R, 1st Edn, Saunders. B N Vijay Raghawa Rao. Cl;inical Exmination in Cardiology 2007, Elsevier. Romeo Vetch ECG diagnosis made easy , Martin Dunitz Hampton John R, The ECG made easy, 6th edn,Churchill livingstone. Lewis. Medical Surgical Nursing Assessment & Management of Problems, 7th Edn. Mosby Publishers. Joyce M Black. Medical Surgical Nursing-Clinical Management for positive outcomes, 7th Edn. Saunders, Mossouri.

Note: * Latest Edition

101

CLINICAL SPECIALITY II MEDICAL SURGICAL NURSING - CRITICAL CARE NURSING

Placement: II Year Hours of instruction Theory: 150 hours Nursing Faculty:-115 hrs External Faculty:-35 hrs Practical: 1450 hours Total : 1600 hours Course Description This course is designed to assist students in developing expertise and in-depth knowledge in the field of Critical Care Nursing. It will help students to develop advanced skills for nursing intervention in caring for critically ill patients. It will enable the student to function as critical care nurse practitioner/ specialist. It will further enable the student to function as educator, manager and researcher in the field of Critical Care Nursing. Objectives At the end of the course the students will be able to 1. Appreciate trends and issues related to Critical Care Nursing. 2. Describe the epidemiology, etiology, pathophysiology and diagnostic assessment of critically ill patients 3. Describe the various drugs used in critical care and nurses responsibility 4. Perform physical, psychosocial & spiritual assessment 5. Demonstrate advance skills/competence in managing critically ill patients including Advance Cardiac Life Support. 6. Demonstrate skill in handling various equipments/gadgets used for critical care 7. Provide comprehensive care to critically ill patients. 8. Appreciate team work & coordinate activities related to patient care. 9. Practice infection control measures. 10. Assess and manage pain. 11. Identify complications & take appropriate measures. 12. Discuss the legal and ethical issues in critical care nursing 13. Assist patients and their family to cope with emotional distress, spiritual, grief and anxiety
102

14. Assist in various diagnostic, therapeutic and surgical procedures 15. Incorporate evidence based nursing practice and identify the areas of research in the field of critical care nursing 16. Identify the sources of stress and manage burnout syndrome among health care providers. 17. Teach and supervise nurses and allied health workers. 18. Design a layout of ICU and develop standards for critical care nursing practice.

103

Content Outline Unit Hours I 5

Content Introduction to Critical Care Nursing Historical review- Progressive patient care(PPC) Review of anatomy and physiology of vital organs, fluid and electrolyte balance, Concepts of critical care nursing, Principles of critical care nursing, Scope of critical care nursing, Critical care unit set up including equipments supplies, use and care of various type of monitors & ventilators,flow sheets.

II

10

Concept of Holistic care applied to critical care nursing practice Impact of critical care environment on patients: Risk factors, Assessment of patients, Critical care psychosis, prevention & nursing care for patients affected with psycho physiological & psychosocial problems of critical care unit, Caring for the patients family, family teaching, The dynamics of healing in critical care unit:-therapeutic touch, Relaxation, Music therapy, Guided Imagery, acupressure, Stress and burnout syndrome among health team members. Prevention & nursing care for patients affected with psycho physiological & psychosocial problems of critical care unit. Caring for the patients family, family teaching..

III

14

Review Pharmacokinetics Analysics/Anti inflammatory agents Antibiotics,antiseptics Drug reaction & toxicity Drugs used in critical care unit ( inclusive of ionotropic , life saving drugs) Drugs used in various body systems IV fluid and electrolytes Blood and blood components Principles of drug administration ,role of nurses and care of drugs.

104

IV

Pain Management Pain & Sedation in Critically ill patients Theories of pain, Types of pain, Pain assessment, Systemic responses to pain pain management-pharmacological and non-pharmacological measures Placebo effect

Infection control in intensive care unit Nosocomial infection in intensive care unit; methycilline resistant, staphylococcus aureus (MRSA), Disinfection, Sterilization, Standard safety measures, Prophylaxis for staff

VI

10 EF3

Gastrointestinal System Causes, Pathophysiology, Clinical types, Clinical features, diagnosis, Prognosis, Management: Medical, Surgical and Nursing management of:-Acute Gastrointestinal Bleeding, Abdominal injury, Hepatic Disorders:-Fulminent hepatic failure, Hepatic encephalopathy, Acute Pancreatitis, Acute intestinal obstruction, perforative peritonitis

VII

10 EF3

Renal System Causes, pathophysiology, Clinical types,Clinical features, diagnosis, Prognosis, Management: Medical, Surgical and Nursing management of:-Acute Renal Failure, Chronic Renal Failure, Acute tubular necrosis, Bladder trauma Management Modalities: Hemodialysis, Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, Continuous arterio venus hemodialysis, Renal Transplantation

VIII

10 EF4

Nervous System Causes, pathophysiology, Clinical types,Clinical features,diagnosis, Prognosis, Management: Medical, Surgical and Nursing management of:-Common Neurological Disorders:Cerebrovascular disease, Cerebrovascular accident, Seizure disorders, GuilleinBarreSyndrome, Myasthenia Gravis, Coma, Persistent vegetative state, Encephalopathy, Head injury, Spinal Cord injury
105

Management Modalities: Assessment of Intracranial pressure, Management of intracranial hypertension, Craniotomy, Problems associated with neurological disorders: Thermo regulation, Unconsciousness, Herniation syndrome IX 5 EF3 Endocrine System Causes,Pathophysiology,Clinical types, Clinical features,diagnosis, Prognosis, Management: Medical, Surgical and Nursing

Management of :-Hypoglycemia, Diabetic Ketoacidosis, Thyroid crisis, Myxoedema, Adrenal crisis, Syndrome of Inappropriate/ hypersecretion of Antidiuretic Hormone (SIADH) X 15 EF4 Management of other Emergency Conditions Mechanism of injury, Thoracic injuries, Abdominal injuries, pelvic fractures, complications of trauma, Head injuries Shock: Shock syndrome, Hypovolemic, Cardiogenic, Anaphylactic, Neurogenic and Septic shock Systemic inflammatory Response: The inflammatory response, Multiple organ dysfunction syndrome Disseminated Intravascular Coagulation Drug Overdose and Poisoning, Acquired Immunodeficiency Syndrome (AIDS) Ophthalmic: Eye injuries, Glaucoma, retinal detachment Ear Nose Throat: Foreign bodies, stridor, bleeding, quincy, acute allergic conditions Psychiatric emergencies;, suicide, crisis intervention XI 20 EF6 Cardiovascular emergencies Principles of Nursing in caring for patients with Cardiovascular disorders Assessment: Cardiovascular system: Heart sounds, Diagnostic studies:- Cardiac enzymes studies, Electrocardiographic monitoring, Holter monitoring, Stress test. Echo cardiography, Coronary angiography, Nuclear medicine studies Causes, Pathophysiology, Clinical types, Clinical features Diagnostic Prognosis, Management : Medical, Surgical &
106

Nursing management of:-Hypertensive crisis, Coronary artery disease,Acute Myocardial infarction, Cardiomyopathy, Deep vein thrombosis, Valvular diseases, Heart block, Cardiac arrhythmias & conduction disturbances, Aneurysms, Endocarditis, Heart failure, Cardio pulmonary resuscitation BCLS/ ACLS Management Modalities: Thrombolytic therapy, Pacemaker temporary & permanent, Percutaneous transluminal coronary, angioplasty, Cardioversion, Intra Aortic Balloon pump monitoring, Defibrillations, Cardiac surgeries, Coronary Artery Bypass Grafts (CABG/MICAS), Valvular surgeries, Heart Transplantation, Autologous blood transfusion, Radiofrequency Catheter Ablation XII 15 EF4

Respiratory System Acid-base balance & imbalance Assesment : History & Physical Examination Diagnostic Tests:Pulse Oximetry, End Tidal Carbon Dioxide,Monitoring, Arterial blood gas studies, chest radiography,pulmonary Angiography, Bronchoscopy, Pulmonary function Test, Ventilation perfusion scan, Lung ventilation scan Causes Pathophysiology, Clinical types, Clinical features,Prognosis, Management: Medical, Surgical and Nursing, management of Common pulmonary disorders:Pneumonia, Status asthmaticus, interstitial drug disease, Pleural effusion, Chronic obstructive pulmonary disease, Pulmonary tuberculosis, Pulmonary edema, Atelectasis, Pulmonary embolism, Acute respiratory failure, Acute respiratory distress syndrome (ARDS), Chest Trauma Haemothorax, Pneumothorax Management Modalities:-Airway Management
107

Ventilatory Management:-Invasive, non- invasive, long term mechanical ventilations Bronchial Hygiene:-Nebulization, deep breathing exercise, chest physiotherapy, postural drainage, Inter Costal Drainage, Thoracic, surgeries

XIII

7 EF2

Burns Clinical types, classification, pathophysiology, clinical features, assessment, diagnosis, prognosis, Management: Medical, Surgical and Nursing management of burns Fluid and electrolyte therapy calculation of fluids and its administration Pain management Wound care Infection control Prevention and management of burn complications Grafts and flaps Reconstructive surgery Rehabilitation

XIV

5 EF2

Obstetrical Emergencies Causes, Pathophysiology, Clinical types, clinical features,diagnostic Prognosis, Management: Medical, Surgical and Nursing management of :Antepartum haemorrhage, Preeclampsia, eclampsia, Obstructed labour and ruptured uterus, Post partum haemorrhage, Peurperal sepsis, Obstetrical shock

XV

10 EF4

Neonatal Paediatric emergencies Causes, pathophysiology, Clinical types, Clinical features,diagnostic, Prognosis , Management: medical, surgical and Nursing, management of o Neonatal emergencies Asphyxia Neonatarum, Pathological Jaundice in Neonates,

108

 Neonatal seizures, Metabolic disorders, Intra cranial Hemorrhage, Neonatal Sepsis, RDS/HMD (Respiratory Distress Syndrome/Hyaline Membrane Disease), Congenital disorders:o Cyanotic heart disease, tracheo oesophageal fistula, congenital hypertropic pyloric stenosis, imperforate anus o Pediatric emergencies Dehydration, Acute broncho pneumonia, Acute respiratory distress, syndrome, Poisoning, Foreign bodies, seizures, traumas, Status asthmaticus XVI 2 Legal and ethical issues in critical care-Nurses role XVII 2 Practical Total = 1450 Hours 1 Week = 48 Hours Brain death Organ donation & Counselling Do Not Resuscitate(DNR) Euthanasia Living will

Quality assurance Standards, Protocols, Policies, Procedures Infection control; Standard safety measures Nursing audit Staffing Design of ICU/CCU

SL.NO

Dept/ Unit

No .of Weeks

1 2 3

Burns ICU Medical I.C.U Surgical I.C.U

2 6 12

109

4. 5 6 7 8

CCU Emergency Department Dialysis Unit Transplant Room Paediatric/NICU Total

2 3 2 2 1 30

Internal Assessment Theory weightage Sessional exams -3 Written assignments 50% 25% 25% Seminars/Presentations Total 100% ESSENTIAL CRITICAL CARE NURSING SKILLS I. Procedures to be observed 1. CT Scan 2. MRI 3. EEG 4. Hemodialysis 5. Endoscopic Retrograde cholangio Pancreaticogram(ERCP) 6. Heart/ Neuro/GI./ Renal Surgeries II. Procedures to be assisted 1. Advanced life support system 2. Basic cardiac life support 3. Arterial line/arterial pressure monitoring/blood taking 4. Arterial blood gas 5. ECG recording 6. Blood transfusion 7. IV cannulation therapy 8. Arterial Catheterization 9. Chest tube insertion 10. Endotracheal intubations 11. Ventilation
110

Practical weightage Ongoing assessment Clinical assignments Internal examination

50% 30% 20%

TOTAL

100%

12. Insertion of central line/cvp line 13. Connecting lines for dialysis III. Procedure to be Performed 1. Airway management a. Application of oropharyngeal airway b. Oxygen therapy c. CPAP (Continuous Positive Airway pressure) d. Care of tracheostomy e. Endotracheal extubation 2. Cardiopulmonary resuscitation, Basic cardiac life support, ECG 3. Monitoring of critically ill patients clinically with monitors, capillary refill time (CRT) assessment of jaundice, ECG. 4. Gastric lavage 5. Assessment of critically ill patients Identification & assessment of risk factors, Glasgow coma scale, and dolls eye movement, arterial pressure monitoring, cardiac output/pulmonary artery pressure monitoring, and detection of life threatening abnormalities 6. Admission & discharge of critically ill patients 7. Nutritional needs gastrostomy feeds, pharyngeal feeds, jejunostomy feeds, TPN, formula preparation & patient education. 8. Assessment of patient for alteration in blood sugar levels monitoring blood sugar levels periodically & administering insulin periodically. 9. Administration of drugs: IM, IV injection, IV cannulation & fixation of infusion pump, calculation of dosages, use of insulin syringes/ tuberculin, monitoring fluid therapy, blood administration. 10. Setting up dialysis machine and starting, monitoring and closing dialysis 11. Procedures for prevention of infections: Hand washing, disinfection & sterilization surveillance, and fumigation universal precautions. 12. Collection of specimen. 13. Setting, use & maintenance of basic equipment, ventilator, O2 analyzer, monitoring equipment, transducers, defibrillator, infusion & syringe pumps, centrifuge machine. IV Other Procedures (If any):

111

REFERENCES Mosely etal , Introduction to Critical Care Nursing, Elseivier 4th Edition Hudak Carolyn M etal. Critical Care Nursing, Saunders Clochesy M John eta,l Critical Care Nursing 2nd edition,.Philadelphia: W.B.Saunders Abels Linda , Critical Care Nursing-A Physiologic Approach, C.V . Mosby Toronto. Bersten D Andrew,SoniNel,Ohs Intensive Care Manual,5th edition ,Elseiver London Dolcun Brian ,Holt Linda Accident and Emergency Care- Theory into Practice, Tindall Marshall S B etal, Neuroscience Critical care- Pathophysiology and Patient Management, Philadelphia: W.B.Saunders Sheppard Mandy, Wright Mike ,Principles and Practice of High Dependancy Nursing, ,Tindall Edinburgh Brbara Montgomery Dossey & Lynn Kelgan. Holistic Nursing. V Edition.Jones and Bartlett Publishers. Pierce, Lynelle N B,. Management of the Mechanically ventilated Patient, 2nd Edn, Elsevier. Tripathi K D, Essential Medical Pharmacology 6th edn, Jaypee. Mckenery & Salerno. Mosbys Pharmacology in Nursing 21st edn. Mosby. Marlow D R and Barbara A R. Textbook of Pediatric Nursing 6th edn. Elsevier. Mac Donald, Averys, M G Martha D M, Mary M K S. NeonatologyPathophysiology and Management of the New Born. Lippincott Williams & Wilkins. Pillitteri, Adelc Maternal & Child Health Nursing. 6th edn. Lippincott. Williams and Wilkins. Cunningham e tal. Williams Obstetrics 23rd edn. M C Graw Hill. Ballantyne J C. The Massachusetts General Hospital Hand Book of Pain Management 3rd edn. Philadelphia: Lippincott Williams and Wilkins. Smeltzer ,Suzanne.C Brunner and Suddarths Text book of Medical surgical Nursing.11th edn :Lippincott. Lewis. Medical Surgical Nursing Assessment & Management of Problems, 7th Edn. Mosby Publishers.
112

CLINICAL SPECIALITY-II MEDICAL SURGICAL NURSING- ONCOLOGY NURSING

Placement : II Year Hours of Instruction Theory : 150 hours Nursing Facculty:-125hrs External Faculty:-25hrs Practicals : 1450 hours

Total : 1600 hours Course Description This course is designed to assist students in developing expertise and indepth understanding in the field of oncology Nursing. It will help students to develop advanced skills for nursing intervention in various oncological conditions. It will enable the student to function as oncology nurse practitioner/specialist and provide quality care. It will further enable the student to function as educator, manager, and researcher in the field of oncology nursing Objectives 1. 2. Explain the prevention, screening and early detection of cancer Describe the epidemiology, etiology, pathophysiology and diagnostic assessment of oncological disorders of various body systems 3. 4. Describe the psychosocial effects of cancer on patients and families. Demonstrate skill in administering/assisting in various treatment modalities used for patients with cancer 5. 6. 7. 8. 9. Apply nursing process in providing holistic care to patients with cancer. Apply specific concepts of pain management Appreciate the care of death and dying patients and value of bereavement support. Describe the philosophy, concept and various dimensions of palliative care. Appreciate the role of alternative systems of medicine in care of cancer patients.

10. Appreciate the legal & ethical issues relevant to oncology nursing 11. Recognize and manage Oncological emergencies 12. Counsel the patients with cancer and their families

113

13. Incorporate evidence based nursing practice and identify the areas of research in the field of oncology nursing 14. Recognize the role of oncology nurse practitioner as a member of oncology team. 15. Collaborate with other agencies and utilize resources in caring for cancer patients. 16. Teach and supervise nurses and allied health workers. 17. Design a layout and develop standards for management of oncology units/hospitals and nursing care. Content outline UNIT I HOURS 4 Introduction II 5 EF5 Epidemiology-Incidence, Prevalence Global, National, State and Local Disease burden, concept of cancer, risk factors Historical perspectives Trends and issues Principles of cancer management Roles and responsibilities of oncology nurse CONTENT

The Nature of Cancer Normal cell biology The Immune system Pathological and pathophysiological changes in tissues o Biology of the cancer cell o Clone formation Transformation o Tumor stem lines o Structure of a solid tumor o Products produced by the tumor o Systemic effects of tumor growth

111

Etiology of Cancer Carcinogenesis Theories of cancer causation Risk factors Carcinogens genetic factors, chemical carcinogens, radiation,viruses, Immune system failure, rapid tissue
114

proliferation Hormone changes, diet, emotional factors.

IV

10 EF5

Diagnostic Evaluation Health assessment: History taking, physical examination, Staging and grading of tumors, TNM Classification Common diagnostic tests o Blood investigation: Haemetological, Biochemical, Tumor markers, Hormonal assay o Cytology:Fine needle aspiration cytology(FNAC) o Histopathology: Biopsy o Radiological assessment: MRI, Ultrasound, Computed tomography, Mammography, Positron emission tomography(PET), Radio nuclide imaging, Functional metabolism imaging o Endoscopies Nurses responsibilities in diagnostic measures

10

Levels of prevention and care Primary prevention Guidelines for cancer detection, general measures, Warning signs of cancer Self examination-Oral, Breast, Testicular Secondary prevention early diagnosis. Screening Tertiary prevention disability limitation, Rehabilitation :Mobility , Speech, Bowel and bladder, Ostomies etc Patient and family education, Discharge instruction, follow-up care and use of community resources.

115

VI

25 EF10

Cancer Treatment Modalities and Nurses Role Surgery Principles of surgical oncology Current surgical strategy, Determining surgical risk Special surgical techniques Pre-intra-postoperative nursing care Acute and chronic surgical complications Future directions and advances Chemotherapy Principles and classification of chemotherapeutics Pharmacology of antineoplastic drugs- Mechanism of action, absorption, protein binding, Bio-transformation, excretion, common side effects, drug toxicity Calculating drug doses, Therapeutic response to chemotherapy-Tumor variables, drug resistance, Safety precautions Radiation Therapy Physics of radiotherapy Types of ionizing rays Radiation equipments:Linear accelerator,cobalt, Implants, Isotopes, Types of therapies: Oral, Brachy therapy, tele therapy, selectron therapy Effects of radiation on the body tissue, Radiation biology cell damage hypoxic cells, alteration of tumor kinetics. Approaches to radiation therapy External radiotherapy Internal radiotherapy unsealed, Sealed sources. Effectiveness of radiotherapy-Radiosensitivity, treatment effects Complications of radiotherapy
116

 Radiation safety: Standards of Bhaba Atomic Research Centre(BARC) Bone Marrow Transplantation/Stem Cell Transplantation Types, Indications, Transplntation procedure, complications and nursing management Types and donor sources Preparation and care of donor and recipient Bone marrow bank Legal and ethical issues

Immunotherapy (Biotherapy) Concepts and Principles Classification of agents Treatment and applications

Gene Therapy Current Concepts and practices

Alternative and Complementary Therapies Current Practices

VII

10

Pain management:- Theories, types and Nature of cancer pain Pathophysiology of pain Pain threshold Assessment of pain Principles of cancer pain control Pharmacological: Opioid and non-opioid analgesic therapy Patient controlled analgesia(PCA) Other invasive techniques of pain control Recent developments in Cancer pain

Non- Pharmacological pain relief technique117

 Complementary therapies(Music, massage, meditation, relaxation techniques, biofeed back etc) Psychological intervention in pain control Alternative system of medicines Role of nurse

VIII

Palliative care Definition and scope, philosophy Concept and elements of palliative care Global and Indian perspective of palliative care Quality of life issues Communication skill Nursing perspective of palliative care and its elements Home care Hospice care Role of nurse in palliative care

IX

Infection control: Process of infection, risk of hospitalization, nosocomial infections- prevention and control of infection in acute, long term care facility and community based care Standard safety measures

30

Nursing Care of Patients With Specific Malignant Disorders Malignancies of G.I. system-oral, oesophagus, stomach, rectal,liver & pancreas, care of ostomies/stoma Respiratory malignancies, Genito urinary system malignancies- prostate Bladder, renal, testicular malignancies, Gynecological malignancies-cervix, uterus, ovary , Hematological malignancies-Lymphomas, Leukemias. Malignancies of musculoskeletal system, Endocrine malignancies Skin
118

Head and Neck -brain tumors, Other malignancies Breast cancer, AIDS related Malignancies(Kaposi's Sarcoma)

XI

10

Paediatric malignancies Leukemia, Lymphoma, Neuro- blastoma Wilms tumor, Soft tissue sarcoma, Retinoblastoma Nursing Management of children with Paediatric Malignancies

XII

15

Nursing Management of Physiological Conditions and Symptoms of Cancer Patient Nutrition: - effects of cancer on nutritional Status and its consequences:-Anemia, Cachexia, Xerostomia, mucositis, Dysphagia , nausea and vomiting, constipation, diarrhoea, electrolyte imbalances, taste alterations Impaired mobility: Decubitus ulcer, pathologic fractures, thrombophlebitis, pulmonary embolism, contractures, footdrop. Other symptoms Dyspepsia & hiccup, dyspnoea intestinal obstruction, Fungating wounds, Anxiety & depression, insomnia, Lymph edema

Impact of cancer on sexuality: Effects of radiotherapy/ chemotherapy/surgery on sexuality of the cancer patient. Nursing management of cancer patients experiencing sexual dysfunction Sexual counseling

119

XIII

10 EF5

Cancer Emergencies Disseminated intravascular coagulation(DIC) Malignant pleural effusion Neoplastic cardiac tamponade and septic shock spinal cord compression Superior venacava syndrome Metabolic emergency: hyper and hypo calcemia. Surgical emergency Urological emergency Hemorrhage Organ obstruction Brain metastasis Nurses role in managing oncologic emergencies

XIV

Psycho-Social Aspects of Nursing Care Psychological responses of patients with cancer Psychosocial assessment Crisis intervention, coping mechanisms Stress management, spiritual/cultural care and needs Counseling: individual and family Maximizing quality of life of patient and family

Ethical, moral and legal issuesEnd of life care Grief and grieving process Bereavement support

Care of Nurses who care for the dying.

Layout and Design of an oncology institution/ ward, OPD, XV 2 chemotherapy unit, Bone marrow transplantation unit, Pain clinic etc Practice Standards of oncology nursing Policies and Procedures Establishing Standing orders and Protocols Quality Assurance Programme in oncology units Nursing audit

120

Clinical Experience Total Hours-1450 1 Week= 48 hours Sl.No 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Dept./Unit Medical oncology ward Surgical oncology ward Bone marrow transplant unit Operation theatre Radiotherapy unit Chemotherapy unit OPD and pain clinic Paediatric oncology ward Palliative care ward Community oncology Hospice Total No. of weeks 6 6 2 2 2 4 2 2 2 1 1 30

Internal Assessment Theory weightage Sessional exams -3 Written assignments 50% 25% 25% Seminars/Presentations Total Procedures to be observed 1. CT Scan 2. MRI 3. PET Scan(Positron Emission Tomography) 4. Ultra sound 5. Mammography 6. Radio Nuclide Imaging
121

Practical weightage Ongoing assessment Clinical assignments Internal examination

50% 30% 20%

100%

TOTAL

100%

7. Bone Scan 8. Thyroid Function Test 9. Functional and Metabolic Imaging 10. Transportation of radioactive materials Procedures to be assisted 1. IV cannulation Open method 2. Chemotherapy 3. Radiotherapy Brachytherapy Low Density Radiation, High Densit Radiation. 4. Interstitial implantation 5. Bio-therapy and Gene therapy 6. Teletherapy Treatment planning 7. Bone marrow aspiration and biopsy 8. Biopsy tissue 9. FNAC Fine Needle Aspiration Cytology and biopsy 10. Advance Cardiac life support 11. Endotracheal intubation 12. Defibrillation Ventilation 13. Tracheostomy 14. Thoracentesis 15. Paracentesis 16. Lumbar Puncture 17. Arterial Blood Gas 18. Nerve Block 19. Chest tube insertion 20. Intercostal drainage 21. CVP monitoring Procedure to be Performed 1. Screening for cancer 2. Assessment of pain 3. Assessment of Nutritionsl status 4. Care of Tracheostomy 5. Endotracheal intubation 6. Gastric gavage 7. Pap smear
122

8. IV cannulation 9. Care of surgical flaps 10. Care of ostomies 11. Blood transfusion and component therapy 12. Counseling 13. Practice standard safety measures 14. Care of dead body and mortuary formalities Other procedures (As per the institutional protocol): 1. Alternative therapies REFERENCES * : Holland, F. James., etal. Cancer Medicine.Philadelphia: Lea &Febiger Price,Pat., etal. Treatment Of Cancer. London:Chapman &Hall Roth, Jack A., etal .Thoracic Oncology. Philadelphia: W.B.Saunders. Haskell ,Charles M .,Cancer Treatment .Philadelphia: W.B.Saunders. Connie Henke Yachro. Barbara Holms Global and Debra W K-Cancer Nurisng. Principles and Practice. 7th edn. Jones and Bartlett Publishers. Martha LanghorneJanet F, S E Otto. Oncology Nursing 5th Edn. Mosby Publishers. Rose A Gates. Regina M Fink-Oncology Nursing secrets. 3rd Edn. Mosby Publishers. Joanne K Itano, Karen N Taoka. Corocurriculum for Oncology Nursing . 3rd edn,W B Saunders. Susan Newton, Margaret Hickey, Joyce Mares. Mosbys Oncology Nurisng Advisor. A comprehensive guide to clinical practice. Mosby Publishers. Price, Pat et.al. Treatment of cancer, Chapman and Hall. Landon.. Haskell, Charles M. Cancer Treatment. W B Saunders. Philadelphia. Smeltzer ,Suzanne.C Brunner and Suddarths Text book of Medical surgical Nursing.11th edn :Lippincott. Lewis. Medical Surgical Nursing Assessment & Management of Problems, 7th Edn. Mosby Publishers. Joyce M Black. Medical Surgical Nursing-Clinical Management for positive outcomes, 7th Edn. Saunders, Mossouri.

Note: * Latest Edition

123

CLINICAL SPECIALITY II MEDICAL SURGICAL NURSING- NEUROSCIENCES NURSING

Placement : II Years Hours of Instruction Theory 150 Hours Nursing Faculty:-110hrs External Faculty:-40hrs Practical- 1450 Hours Total : 1600 Hours

Course Description This course is designed to assist students in developing expertise and indepth knowledge in the field of neurology and neurosurgical Nursing. It will help students to develop advanced skills for nursing intervention in caring for patients with neurological and neurosurgical disorders. It will enable the student to function as neuroscience nurse practitioner/ specialist. It will further enable the student to function as educator, manager and researcher in the field of neurology and neurosurgical Nursing.

Objectives At the end of the course the students will be able to 1. Appreciate trends and issues related to Neurology and Neurosurgical Nursing. 2. Review the anatomy and physiology of Nervous system 3. Describe the epidemiology, etiology, pathophysiology and diagnostic assessment of patients with Neurological and Neurosurgical disorders 4. Perform Neurological assessment and assist in diagnostic procedures 5. Describe the concepts and principles of Neuroscience nursing 6. Describe the various drugs used in neurosciences and nurses responsibility 7. Assist in various therapeutic and surgical procedures in Neuroscience nursing. 8. Demonstrate advance skills/competence in managing patients with neurological and neurosurgical disorder following nursing process approach 9. Identify psychosocial problems of patients with disabilities and assist patients and their family to cope with emotional distress, spiritual, grief and anxiety 10. Participate in preventive, promotive and rehabilitative services for neurological and neurosurgical patients.
124

11. Explain the legal and ethical issues related to brain death, organ transplantation and practice of neuroscience nursing 12. Incorporate evidence based nursing practice and identify the areas of research in the field of neuroscience nursing 13. Organise and conduct inservice education program for nursing personnel. 14. Develop standards of care for quality assurance in neuroscience nursing practice 15. Identify the sources of stress and manage burnout syndrome among health care providers. 16. Teach and supervise nurses and allied health workers. 17. Plan and develop physical layout of neuro intensive care unit Unit I Hours 5 Introduction Introduction to neuroscience(neurological and neurosurgical) nursing History-Development in neurological and neurosurgical nursing, Service & education Emerging trends and issues in neurology and Neurosurgery and its implication to nursing. Neurological and Neurosurgical problems Concepts, principles and nursing perspectives Ethical and legal issues Evidence based nursing and its application in Neurological and neurosurgical nursing. II 5 Epidemiology Major health problems Risk factors associated with neurological conditions- Hereditary, Psychosocial factors, smoking, alcoholism, dietary habits, cultural and ethnic considerations, occupational and infections. Health promotion, disease prevention, lifestyle modification and its implications to nursing. Alternate system of medicine/complementary therapies III 10 Review of Anatomy and physiology Embryology Structure and functions of Nervous system- CNS, ANS,
125

Content

cereberal circulation , cranial and spinal nerves and reflexes, motor and sensory functions. Sensory organs IV 15 EF4 Assessment and diagnostic measures Assessment History taking Physical assessment, psychosocial assessment Neurological assessments, Glasgow coma scale interpretation & its relevance to nursing. Common assessment abnormalities Diagnostic measures Cerebro spinal fluid analysis Radiological studies-Skull and spine X-ray Cerebral Angiography, CT Scan, Single Photon Emission Computer

Tomography(SPECT), MRI (Magnetic Resonance Imaging), MRA, MRS, Functional MRI, Myelography, PET (Positron Emission Test), Interventional radiology. Electorgraphic studies- Electro encephalo graphy, MEG, EMG ,video EEG Nerve conduction studies-Evoked potentials, visual evoked

potentials, brain stem auditory evoked potentials, somatosensory evoked potentials Ultrasound sonography, Immunological studies Biopsies muscle, nerve and Brain. Interpretation of diagnostic measures Nurses role in diagnostic tests V 5 Meeting Nutritional needs of neurological patients Basic nutritional requirements Metabolic changes following injury and starvation Nutritional assessment Common neurological problems that interfere with nutrition and strategies for meeting their nutritional needs
126

studies-Carotid

duplex,

transcranial

Doppler

 VI 5

Special metabolic and electrolyte imbalances Chronic fatigue syndrome

Drugs used in neurological and neurosurgical disorders Classification Indications, contraindications, actions and effects, toxic effects

Role of nurse VII 10 EF3 Traumatic conditions. Causes, pathophysiology, Clinical types, Clinical features, diagnosis, Prognosis, Management: medical, surgical and Nursing management of Cranio cerebral injuries. Spinal & Spinal cord injuries. Peripheral nerve injuries. Unconsciousness VIII 10 EF3 Cerebro vascular disorders. Causes, pathophysiology, Clinical types, Clinical features, diagnosis, Prognosis , Management: medical, surgical and Nursing management of Stroke & arterio venous thrombosis. Arterio venous fistula. Brain tumours Diseases of cranial nerves; Trigeminal neuralgia, Facial palsy, Bulbar palsy. IX 10 EF5 Degenerating and demyelinating disorders Causes, pathophysiology, Clinical types, Clinical features, diagnostic, Prognosis , Management: medical, surgical and Nursing management of Motor neuron diseases. Movement disorders- Tics, dystonia, chorea, wilsons disease,essential tremors Dementia. Parkinsons disease. Multiple sclerosis. Alzemiers
127

10 EF5

Neuro infections Causes, pathophysiology, Clinical types, Clinical features, diagnostic, Prognosis , Management: medical, surgical and Nursing management of Neuro infections Meningitis-types Encephalitis. Poliomyelitis. Parasitic infections. Bacterial infections Neurosyphilis. HIV & AIDS. Brain abscess.

XI

10 EF2

Paroxysmal disorders. Causes, pathophysiology, Clinical types, Clinical features, diagnosis, Prognosis , Management: medical, surgical and Nursing management of Epilepsy and seizures. Status epilepticus. Syncope. Meniers syndrome. Cephalgia.

XII

10 EF5

Developmental disorders. Causes, pathophysiology, Clinical types, Clinical features, diagnostic, Prognosis , Management: medical, surgical and Nursing management of Hydrocephalus. Craniosynostosis. spina bifida- Meningocele, Meningomyelocele encephalocele syringomyelia. Cerebro vascular system anomalies. Cerebral palsies. Downs syndrome

128

XIII

10 EF5

Neuro muscular disorders. Causes, pathophysiology, Clinical types, Clinical features, diagnostic, Prognosis , Management: medical, surgical and Nursing management of Polyneuritis G B Syndrome. Muscular dystrophy. Myasthenia gravis. Trigeminal neuralgia. Bells palsy. Meniers disease Carpal tunnel syndrome Peripheral neuropathies Neoplasms surgical conditions. Causes, pathophysiology, Clinical types, Clinical features, diagnostic, Prognosis , Management: medical, surgical and Nursing management of Space occupying lesions -types Common tumors of CNS

XIV

5 EF2

XV

Other disorders Causes, pathophysiology, Clinical types, Clinical features, diagnostic, Prognosis , Management: medical, surgical and Nursing management of Metabolic disorders- diabetes insipidus, metabolic encephalopathy Sleep disorders Auto immune disorders- multiple sclerosis, inflammatory myopathies

XVI

10 EF4

Neuro emergencies Causes, pathophysiology, Clinical types, Clinical features, diagnostic, Prognosis , Management: medical, surgical and Nursing management of Increased intracranial pressure Unconscious
129

 Herniation syndrome Seizures Severe head injuries Spinal injuries Cerebro vascular accidents XVII 5 EF2 Rehabilitation. Concept and Principles of Rehabilitation. Factors affecting quality of life and coping Rehabilitation in acute care setting, and following stroke, head injury and degenerative disorders of brain Physiotherapy. Counselling Care givers role Speech & Language. Neurogenic communication disorders, Speech Therapy XVIII 5 Ethical and legal issues in neuroscience nursing Brain death and organ transplantation Euthanasia Negligence and malpractice Nosocomial infections XIX 5 Quality assurance in neurolgical nursing practice Role of advance practitioner in neurological nursing Professional practice standards Quality control in neurologic nursing Nursing audit Neuro ICU Philosophy, aims and objectives Policies, staffing pattern, design and physical plan of neuro ICU Team approach, functions Psychosocial aspects in relation to staff and clients of neuro ICU In-service education.
130

Practical Total =1450 Hours 1 Week = 48 Hours

SL.No 1. 2. 3. 4. 5. 6. 7. 8. 9 10 11 12

Dept/ Unit O.P.D Casualty Diagnostics Neuro Psychiatry Pediatric Neuro ward Neuro Surgical Ward Head Injury Ward I.C.U Nero Medicine I.C.U Nero Surgical Neuro Medical Ward Rehabilitation OT Total

Weeks 1 2 1 2 2 3 3 4 4 4 2 2 30

Internal Assessment Theory weightage Sessional exams -3 Written assignments 50% 25% 25% Seminars/Presentations Total 100% TOTAL 100% Practical weightage Ongoing assessment Clinical assignments Internal examination 50% 30% 20%

ESSENTIAL NEURO NURSING SKILLS I. Procedures to be observed 1. CT scan 2. MRI 3. PET

131

4. EEG 5. EMG 6. Sleep pattern studies/Therapy 7. Radiographical studies 8. Neuro surgeries 9. Nerve conduction studies 10. Ultrasound studies II. Procedures to be assisted 1. Advanced Cardiac life support 2. Lumbar Puncture 3. Biopsies muscle, nerve and Brain 4. Arterial Blood Gas 5. ECG Recording 6. Blood transfusion 7. IV cannulation open method 8. Endotracheal intubation 9. Ventilation 10. Tracheostomy 11. ICP monitoring 12. Gama Knife 13. Cereberal angiography 14. Myelography 15. Neuro surgeries III. Procedures to be Performed: 1. Airway management a. Application of Oro Pharyngeal Airway b. Care of Tracheostomy c. Conduct Endotracheal Intubation d. use of AMBU bag, artificial respirators e. Setting of Ventilators and Care of patients on ventilators 2. Cardio Pulmonary Resuscitation -Defibrillation 3. Neurological assessment -Glasgow coma scale 4. Gastric Lavage 5. IV Cannulation
132

6. Administration of emergency IV Drugs, fluid 7. Care of patients with incontinence, bladder training ,Catheterization 8. Care of patients on traction related to the neurological conditions 9. Blood Administration. 10. Muscle strengthening exercises 11. Guidance and counseling 12. Monitoring management and care of monitors. IV. Other Procedures if any:

REFERENCES *: Walton John, Brain Diseases of the Nervous system,10th Edition Hickey.V.Joanne, The Clinical Practice of Neurological and Neurosurgical Nursing,4th Edition,Lippincott Company Marshall.S.Randolph and Mayer.aA.Stephen, On call Neurology,Harcourt Brace & Company Koye.H.Andrew, Essential NeuroSurgery,2nd Edition,Churchill Livingstone Company. Hopkins Anthony,Clinical Neurology-A ModernApproach,Oxford University Publications Barker Ellen ,NeuroScience Nursing,A Spectrum of Care,2nd Edition,Mosby Company R.M.Kirk.General Surgical Operations.Vth Edition,Mosby Publishers. Kenneth.W.Lindsay & Ian Bone.Neurology and Neurosurgery Illustrated,1Vth Edition,ChurchillLiving Stone. Lynelle.N.B.Pierce.Management of the mechanically ventilated patient.11nd Edition.Elsevier.Mosby Publishers. Shaila,Shodhan,Kamat.Practical application of mechanical ventilation.1st Edition,Jaypee publishers. Loren.A.Rolak.Neurology Secrets.1st Edition.Mosby Publishers. Christopher.M.Brammer & M.Catherine Spires.Manual of Physical Medicine & Rehabilitation,1st Edition,Mosby Publishers. Tandon P.N.and Ramamurthi.B, Textbook of NeuroSurgery, 2nd Edition,Churchill Livingstone Company
133

 Agarwal.A.K, Recent Concepts in Stroke, Indian College of Physicians Wadia .H. Noshir, Neurological Practice-An Indian Perspective,Elsevier,2005 Umphred.A.Dancy,Neurological Rehabilitation,5th Edition,Mosby. Charis Stewert Anidei, Joyce A Kunkel. Hanns Neuroscience Nursing: Human Response to Neurologic Dysfunction (2001) 2nd edition W B Saunders. Sue Wood Ward, Catheryne Waterhouse. Oxford handbook of neuroscience Nursing (2009) Oxford University Press. Prema T P, K F Grace. Essentials of Neurological and Neurosurgery Nursing(2002) Jaypee brothers. Marilynn Mitchell. Neuroscience Nursing-A Nursing process approach . Williams Wilkins. Kenneth., W Lindsay & Ian Bone. Neurology and Neurosurgery illustrated, Churchil livingsone Lynelle N B Pierce. Management of the mechanically ventilated patient. Elsevier. Brammer C M & M Catheryne Spiris. Manual of physical medicine and rehabilitation. Elsevier. Smeltzer ,Suzanne.C Brunner and Suddarths Text book of Medical surgical Nursing.11th edn :Lippincott. Lewis. Medical Surgical Nursing Assessment & Management of Problems, 7th Edn. Mosby Publishers. Joyce M Black. Medical Surgical Nursing-Clinical Management for positive outcomes, 7th Edn. Saunders, Mossouri.

Note: * Latest Edition ******

134

CLINICAL SPECIALITY II MEDICAL SURGICAL NURSING- NEPHRO-UROLOGY NURSING

Placement : II Year Hour of Instruction Theory : 150 Hours Nursing Faculty:-105hrs External Faculty:-45hrs Practical : 1450 Hours Total : 1600 Hours Course Description This course is designed to assist students in developing expertise and indepth understanding in the field of Nephro and urological Nursing. It will help students to develop advanced skills for nursing intervention in various nephro and urological conditions. It will enable the student to function as nephro and urology nurse practitioner/specialist and provide quality care. It will further enable the student to function as educator, manager, and researcher in the field of nephro and urology nursing Objectives At the end of the course the students will be able to: 1. Appreciate trends and issues related to nephro and urological nursing. 2. Describe the epidemiology, etiology, pathophysiology and diagnostic assessment of nephro and urological conditions 3. Perform physical, psychosocial & spiritual assessment. 4. Assist in various diagnostic, therapeutic and surgical interventions. 5. Provide comprehensive nursing care to patients with nephro and rological conditions. 6. Describe the various drugs used in nephro and urological conditions and nurses responsibility. 7. Demonstrate skill in handling various equipments/gadgets used for patients with nephro and urological conditions.
135

8. Appreciate team work & coordinate activities related to patient care. 9. Practice infection control measures. 10. Identify emergencies and complications & take appropriate measures. 11. Assist patients and their family to cope with emotional distress, grief, anxiety and spiritual needs. 12. Discuss the legal and ethical issues in nephro and urological nursing 13. Identify the sources of stress and manage burnout syndrome among health care providers. 14. Appreciate the role of alternative system of medicine in the care of patient. 15. Incorporate evidence based nursing practice and identify the areas of research in the field of nephro and urological nursing. 16. Teach and supervise nurses and allied health workers. 17. Design a layout of kidney transplant unit and dialysis unit. 18. Develop standards of nephro urological nursing practice. COURSE CONTENT Unit I Hours 5 Introduction Historical development: trends and issues in the field of nephro and urological nursing. Nephro and urological problems Concepts,principles & nursing perspectives Ethical and legal issues Evidence based nursing and its application in nephro & urological nursing (to be incorporated in all the units) II 5 Epidemiology Major health problems- urinary dysfunction, urinary tract infections, Glomuerular disorders, obstructive disorders ad other urinary disorders. Risk factors associated with nephro and urological conditions Hereditary, Psychosocial factors, smoking, alcoholism, dietary habits, cultural and ethnic considerations.
136

Content

Health promotion, disease prevention, life style modification and its implications to nursing. Alternate system of medicine/complementary therapies

III

Review of anatomy and physiology of urinary system Embryology Structure and functions Renal circulation Physiology of urine formation Fluid and electrolyte balance Acid base balance Immunology specific to kidney

IV

20 EF12

Assessment and diagnostic measures History taking Physical assessment, psychosocial assessment Common assessment abnormalities-dysurea,frequency, enuresis, urgency, hesistancy, hematuria, pain, retention, burning on urination, pneumaturia, incontinence, nocturia, polyurea, anuria, oliguria, Diagnostic tests-urine studies,blood chemistry, radiological procedures-KUB,IVP, CT scan nephrotomogram,retrograde pylogram, renal arteriogram, renalultrasound, , MRI, cystogram, renal scan, biopsy, endoscopy-cystoscopy, urodynamics studiescystometrogram, urinary flow study, sphincter electromyography, voiding pressure flow study, videourodynamics, Whitaker study. Interpretation of diagnostic measures. Nurses role in diagnostic tests.

5 EF5

Renal immunopathy/Immunopathology General Concept of immunopathology. Immune mechanism of glomerual vascular disease. Role of mediater systems in glomerula vascular disease.
137

VI

15 EF5

Urological Disorders and Nursing Management Etiology,clinical manifestations, diagnosis,prognosis, related pathophysiology,medical,surgical & nursing management of Urinary tract infections- pyelonephritis, lower urinary tract infections. Disorders for ureters, bladder and urethra. Urinary tract infections. Urinary dysfunctions- urinary retention, urinary incontinence, urinary reflux. Bladder disorders- neoplasms, calculi, neurogenic bladder, trauma,congenital abnormalities. Benign prostrate hypertrophy(BPH). Ureteral disorders: ureteritis, ureteral trauma, congenital anomalies of ureters. Uretheral disorders- tumours, trauma, congenital anomalies of ureters.

VII

25 EF5

Glomerular disorders and nursing management Etiology, clinical manifestations, diagnosis, prognosis, related pathophysiology, medical , surgical and nursing management of Glomuerulo nephritis- chronic, acute , nephrotic syndrome. Acute Renal failure and chronic renal failure. Renal calculi. Renal tumours-benign and malignant. Renal trauma. Renal abscess. Diabetic nephropathy. Vascular disorders. Renal tuberculosis. Polycystic. Congenital disorders. Hereditary renal disorders.

V111

10 EF4

Management of Renal emergencies Anuria Acute Renal failure

138

Poisoning Trauma Urine retention Acute graft rejection Hematuria Nurses role

1X

10

Drugs used in urinary disorders Classification Indications, contraindications, actions & effects,toxic effects Role of nurse.

10 EF4

Dialysis Dialysis- Historical, types, Principles, goals Hemodialysis- vascular access sites- temporary and permanent Peritoneal dialysis Dialysis Procedures- steps,equipments,maintenance. Role of nurse pre dialysis, intra and post dialysis, Complications Counseling Patient education Records and reports.

XI

10 EF6

Kidney transplantation Nursing management of a patient with kidney transplantation Kidney transplantations- a historical review Immunology of graft rejections The recipient of a renal transplant Renal preservations. Human Leucocytic Antigen(HLA) typing matching and cross matching in renal transplantation Surgical techniques of renal transplantations. Chronic renal transplant rejection Complication after KTP: Vascular and lymphatic, Urological, cardiovascular, liver and neurological, infectious complication.
139

 XII 5 XIII 10 EF4

KTP in children and management of pediatric patient with KTP KTP in developing countries Results of KTP Work up of donor and recipient for renal transplant Psychological aspect of KTP and organ donations Ethics in transplants, Cadaveric transplantation.

Rehabilitation of patient with nephrological problems Risk factors and prevention. Rehabilitation of patients on dialysis and after kidney transplant Rehabilitation of patients after urinary diversions Family and patient teaching

Pediatric urinary disorders Etiology, clinical manifestations, diagnosis, prognosis, related pathophysiology, medical,surgical and nursing management of children with Renal Diseases -UTI, ureteral reflux, glomerulonephritis, nephrotic syndrome infantile nephrosis, cystic kidneys,familial factors in renal diseases in childhood, Haemolytic uraemic syndrome. Benign recurrent haemturia, nephropathy, wilms tumour.

XIV

Critical care units- dialysis , KTP unit Philosophy, aims and objectives Policies, staffing pattern, design and physical plan of Dialysis and KTP units, Team approach, functions, Psychosocial aspects in relation to staff and clients of ICU, dialysis unit, In-service education, Ethical and legal issues.

XV

Quality assurance in nephrological nursing practice Role of advance practioner in nephrological nursing. Professional practice standards Quality control in nephrological nursing Nursing audit.

140

Practicals Total = 1450 Hours 1 Week = 48 Hours SL.No 1. 2. 3. 4. 5. 6. 7 8. 9 10 Dept/Unit Nephrology Ward Pediatrics Critical Care Unit Urology Ward Dialysis Unit Kidney Transplantation Unit Uro OT Emergency Wards Uro/ Nephro OPDs Diagnostic Labs Total Weeks 6 2 2 6 4 2 2 2 3 1 30 Hours 288 96 96 288 192 96 96 96 144 40 1450

Internal Assessment Theory weightage Sessional exams -3 Written assignments 50% 25% 25% Seminars/Presentations Total Procedures to be observed I. Procedures Observed 1. CT Scan 2. MRI 3. Radiographic studies 4. Urodynamics 5. Hemodialysis 6. Renal Surgeries 100% TOTAL 100% Practical weightage Ongoing assessment Clinical assignments Internal examination 50% 30% 20%

141

II. Procedures to be assisted 1. Blood transfusion 2. I V cannulation therapy 3. Arterial Catheterization 4. Insertion of central line/cvp line 5. Connecting lines for dialysis 6. Peritoneal dialysis 7. Renal biopsy 8. Endoscopies- Bladder, urethra III. Procedures to be performed 1. Health assessment 2. Insertion of urethral and suprapubic catheters 3. Urine analysis 4. Catheterisation 5. Peritoneal dialysis 6. Bladder irrigation 7. Care of ostomies 8. Care of urinary drainage 9. Bladder training 10. Care of vascular access 11. Setting up dialysis machine and starting, monitoring and closing dialysis 12. Procedures for prevention of infections: 13. Hand washing, disinfection & sterilization surveillance,fumigation and universal precautions. 14. Collection of specimen. 15. Administration of drugs: IM, IV injection, IV cannulation & fixation of infusion pump, calculation of dosages, blood administration. imbalance. 16. Nutritional needs , diet therapy & patient education. 17. Counselling IV. OTHER PROCEDURES IF ANY: REFERENCES *: Walsh, Patrick C.. etal. , Campbells Urology. Philadelphia:W.B. Saunders{latest edition)
142

Monitoring -fluid therapy, electrolyte

 Pollack, Howard M .etal., Clinical urography..:Philadelphia:W .B . Saunders {latest edition} Morris, Peter J., Kidney Transplantation. Philadelphia: W.B.Saunders Bobbee Terrill, Renal Nursing-A Practical approach,Ausmed Publications. Allen.R.Nissenson &Richard.N.Fine Handbook of Dialysis Therapy,4th Edition,Elsevier. John.T.Daugirdas,Peter.G.Blake,Todd.S.Ing.Handbook of Dialysis,1Vth Edition.Lippincott Williams &Wilkins. Judith.Z.Kallenbach.Review of Hemodialysis for Nurses & Dialysis Personnel.V11th Edition,Mosby Publications. Krane ,Robert J., etal. Operative Urology .Newyork: Churchill Livingstone Brenner, Barry M., & Stein, Jay H., Chronic Renal Failure. Newyork :Churchill Livingstone Schrier, Robert W., & Gottschalk, Carl W., Diseases Of The Kidney .Boston: Little Brown Co. Brenner, Barry M .,The Kidney. Philadelphia: W.B.Saunders Levine, David Z., Caring For The Renal Patient.. Philadelphia:W.B.Saunders Nicola Thomas,Renal Nursing.2nd Edition,Elsevier. Jeremy Levy,Edwina Brown,Julie Morgan.Oxford Hand book of Dialysis-A Practical guide to dialysis and how to manage End Stage Renal Failure.Oxford University Press. Paul Challinor,John Sedgewick.Principles and Practice of Renal Nursing.Nelson Thornes Limited. Christopher.J.Lote.Principles of Renal Physiology.Kluwer Academic Publishers. Smeltzer ,Suzanne.C Brunner and Suddarths Text book of Medical surgical Nursing.11th edn :Lippincott. Lewis. Medical Surgical Nursing Assessment & Management of Problems, 7th Edn. Mosby Publishers. Joyce M Black. Medical Surgical Nursing-Clinical Management for positive outcomes, 7th Edn. Saunders, Mossouri.

Note: * Latest Edition

143

CLINICAL SPECIALITY II MEDICAL SURGICAL NURSING - ORTHOPEDIC NURSING

Placement : II Year Hours of Instruction Theory : 150 Hours Nursing Faculty:- 110hrs External Faculty:- 40hrs Practical :1450 Hours Total : 1600 Hours Course Description This course is designed to assist students in developing expertise and indepth understanding in the field of orthopedic nursing. It will help students to develop advanced skills for nursing intervention in various orthopedic conditions. It will enable the student to function as orthopedic nurse practitioner/specialist providing quality care. It will further enable the student to function as educator, manager, and researcher in the field of orthopedic nursing. Objectives At the end of the course the students will be able to: 1. 2. 3. Appreciate the history and developments in the field of orthopedic nursing Identify the psycho-social needs of the patient while providing holistic care. Perform physical and psychological assessment of patients with orthopedic conditions and disabilities. 4. 5. 6. Describe various disease conditions and their management Discuss various diagnostic tests required in orthopedic conditions Apply nursing process in providing care to patients with orthopedic conditions and those requiring rehabilitation. 7. 8. Recognize and manage orthopedic emergencies. Describe recent technologies and treatment modalities in the management of patients with orthopedic conditions and those requiring rehabilitation. 9. Integrate the concept of family centered, long term care and community based rehabilitation to patients with orthopedic conditions. 10. Counsel the patients and their families with orthopedic conditions 11. Describe various orthotic and prosthetic appliances
144

12. Appreciate the legal and ethical issues pertaining to patients with orthopedic conditions and those requiring rehabilitation. 13. Appreciate the role of alternative system of medicine in care of patients with orthopedic conditions 14. Incorporate evidence based nursing practice and identify the areas of research in the field of orthopedic nursing. 15. Recognize the role of orthopedic nurse practitioner and as a member of the orthopedic and rehabilitation team. 16. Teach orthopedic nursing to undergraduate students and in-service nurses. 17. Prepare a design and layout of orthopedic and rehabilitative units.

COURSE CONTENT UNIT I HOURS 5 II 8 CONTENT Introduction Historical perspectives History and trends in orthopedic nursing Definition and scope of orthopedic nursing Anatomy and physiology of Musculo-skeletal system Posture,Body landmarks Skeletal system, Muscular system,Nervous system - Main nerves Healing of - Injury, bone injury, Repair of ligaments Systemic response to injury Ergonomics,Body mechanics,biomechanical measures Orthopedic team

Assessment of Orthopedic Patient Health Assessment: History, physical examinationinspection,palpation, movement, Measurement, muscle strength testing. Diagnostic studies Radiological studies, Muscle enzymes,serologic studies.

III

10 EF3

Care of patients with devices Splints, braces, various types of plaster cast Various types of tractions, Various types of orthopedic beds and mattresses
145

 IV 15 EF5

Comfort devices Implants in orthopedic Prosthetics and Orthotics

Injuries Trauma & Injuries Causes, pathophysiology, clinical types, clinical features,diagnosis, prognosis, management, medical surgical and nursing management of : Early management of Trauma Fractures Injuries of the Shoulder and arm, Elbow, fore arm, wrist, hand , Hip, thigh, knee, leg, ankle, foot, Spine. Head injury Chest injury. Polytrauma Nerve injuries Vascular injuries Soft tissue injuries Sports injuries Amputation

8 EF3

Infections of Bones and Joints Causes, pathophysiology, clinical types, clinical features,diagnosis, prognosis, management, medical surgical and nursing management of : Tuberculosis Osteomyelitis Arthritis Leprosy

V1

5 EF2

Bone Tumours Causes, pathophysiology, clinical types, clinical features, diagnosis, prognosis, management, medical surgical and nursing management of:
146

 Bone tumors Benign, Malignant and metastatic Different types of therapies for tumors VII 10 EF5 Deformities Causes, pathophysiology, clinical types, clinical features, diagnosis, prognosis medical surgical and nursing management of:Scoliosis, Kyphosis,Lordosis Congenital disorders: Congenital dislocation of hip(CDH), Dislocation of patella, knee. Varus and valgus deformities. Deformities of digits,Congenital torticollis Meningocele, meningomyelocele, spina bifida Chromosomal disorders, Computer related deformities.

VIII

5 EF2

Disorders of the spine Intervertebral disc prolapse, Fracture of the spine Low back disorder Low back pain, PND, spinal stenosis, spondylosis

IX

5 EF2

Nutritional/Metabolic and Endocrine Disorders Causes, pathophysiology, clinical types, clinical features, diagnosis, prognosis, medical surgical and nursing management of: Rickets, Scurvy, Hypervitaminosis A and D, Osteomalacia, Osteoporosis Pagets disease, gout Gigantism, Dwarfism, Acromegaly. Therapeutic diets for various orthopedic disorders.

8 EF3

Neuro-Muscular Disorders: Causes, pathophysiology, clinical types, clinical features,diagnosis, prognosis, medical, surgical and nursing management of: Poliomyelitis, Cerebral Palsy Myasthenia gravis
147

 Spina bifida. Peripheral nerve lesion, Paraplegia, Hemiplegia, Quadriplegia. Muscular dystrophy

XI

8 EF3

Chronic/Degenerative Diseases of Joints and Autoimmune Disorders: Causes, pathophysiology, clinical types, clinical features, diagnosis, prognosis,medical, surgical and nursing management of: Osteo Arthritis Rheumatoid Arthritis Ankylosing spondylitis. Spinal disorders. Systemic Lupus Erythematosus

XII

5 EF2

Orthopedic Disorders in Children: General and special consideration on pediatric orthopedics Genetic disorders Congenital anomalies Growth disorders Genetic counseling Nurses role in genetic counseling

XIII

Geriatric Problems Geriatric population, types of disabilities, causes, treatment and management Hospitalization, rest, physiotherapy, involvement of family members, social opportunities. Care at home involvement of family and community, follow up care and rehabilitation

XIV

Pharmacokinetics Principles of drug administration Analgesics and anti inflammatory agents Antibiotics, Antiseptics Drugs used in orthopedics & neuromuscular disorders Blood and blood components
148

 30 XV EF10

Care of drugs and nurses role

Nurses Role in Orthopedic Conditions Gait analysis Urodynamic studies Prevention of physical deformities Alteration of body temperature regulatory system and immune systems Immobilization cast, splints, braces and tractions Prevention and care of problems related to immobility Altered sleep patterns Impaired communication Self care and activities of daily living Bladder and bowel rehabilitation Sensory function rehabilitation Psychological reaction related to disabilities & disorders. Coping of individual & family with disabilities and disorders Maintaining sexuality Spirituality A rehabilitative prospective Replacement surgeries Hip, Knee, Shoulder, Spine surgeries, Grafts & flaps surgery,Deformity correction. Physiotherapy Concepts, Principles, purpose Mobilization Exercises: types, re-education in walking: Crutch walking, wheel chair, Transfer techniques. Types of gaits: Non-weight bearing, partial weight bearing, four point crutch, tripoid, walking with sticks, calipers Forms of therapies: Hydrotherapy, electrotherapy, wax bath, heat therapy, ice, helio therapy, radiant heat. Chest physiotherapy
149

Orthopedic Reconstructive Surgeries

XVI

Rehabilitation Principles of rehabilitation, definition, philosophy, process Various types of therapies, Special therapies and alternative therapies Rehabilitation counseling Preventive and restorative measures. Community based rehabilitation (CBR) Challenges in rehabilitation Role of the nurse in rehabilitation. Legal and ethical issues in rehabilitation nursing Occupational therapy.

XVII

National Policies and Programmes National programmes for rehabilitation of persons with disability National Institutes, artificial limbs manufacturing corporation,District rehabilitation centers and their schemes, Regional rehabilitation centers etc. Public policy in rehabilitation nursing The persons with disabilities act 1995 Mental rehabilitation & Multiple disabilities act 1992 The National Trust Rules 1999 and 2000 Rehabilitation Council of India Legal and ethical aspects in orthopedic nursing Rehabilitation health team and different categories of team members.

XVIII

Quality assurance Standards, Protocols, Policies, Procedures, Nursing audit, Staffing, Design of orthopedic, physiotherapy and rehabilitation unit.

Practicals 1. Clinical practice in Orthopedic, physiotherapy& rehabilitation units. 2. Application of tractions and plaster casts and removal of tractions and plaster casts and other appliances.
150

3.

Apply Theories and Nursing Process in the management of patients with orthopedic conditions.

4. 5. 6.

Provide various types of physical and rehabilitative therapies Provide health education on related disease conditions. Unit management and plan designing

Clinical Experience Total = 1450 Hours 1 Week =48 Hours SL.NO 1. 2 3 4 5 6 7 8 9 Dept/ Unit Orthopedic Ward Orthopedic OT Neuro Surgical Ward Orthopedic O.P.D Casualty/ Emergency/ Trauma Rehabilitation Unit Physiotherapy Unit Pediatric/ pediatric Surgery Unit Field Visit Total Weeks 8 4 2 2 4 2 4 2 2 30

Internal Assessment Theory weightage Sessional exams -3 Written assignments 50% 25% 25% Seminars/Presentations Total Procedures to be observed 1. X Ray 2. Ultrasound 3. MRI 4. C T Scan/bone scan
151

Practical weightage Ongoing assessment Clinical assignments Internal examination

50% 30% 20%

100%

TOTAL

100%

5. Arthroscopy 6. Electrothermally assisted capsule shift or ETAC (Thermal capsulorrhaphy) 7. Fluroscopy 8. Electromyography 9. Myelography 10. Discography 11. Others Procedures to be assisted 1. Blood Transfusion 2. 3. 4. 5. IV cannulation and therapy Ventilation Various types of tractions Orthopedic surgeriesArthrocentesis, Arthroscopy, Bone lengthening,

Arthrodesis, grafting, Fractures fixation, reconstructive,reimplantation, replanation, spinal decompression, transplantation of bone, muscle or articular cartilage,

autografting, allografting. 6. 7. Injection Intra articular, intra osseous. Advance Life Support

Peocedures to be Performed 1. 2. 3. 4. 5. 6. 7. 8. 9. Interpretation of X ray films. Application and removal of splints, casts, and braces. Care of tractions skin and skeletal traction, pin site care. Cold therapy. Heat therapy Hydrotherapy Therapeutic exercises Use of TENS (Transcutaneous electrical nerve stimulation) Techniques of transportation

10. Crutch walking, walkers, wheel chair. 11. Use of devices for activities of daily living and prevention of deformities. 12. Administration of drugs: IV injection, IV cannulation, and Blood transfusion. 13. Procedures for prevention of infections: disinfection and sterilization, surveillance, fumigation. 14. Special skin/ part preparations for orthopedic surgeries.
152

15. Surgical dressings Debridement. 16. Bladder and bowel training Other Procedures if any. REFERENCES * : Riggs, Lawrence B .,& Melton, Joseph L.,. Osteoporosis. Philadelphia: Lippincott Solomon, Louis. etal .ApleysSystem Of Orthopaedics And Fractures. London : Adams, John Crawford.& Hamblen, David L., Outline Of Orthopaedics. .Edinburgh : Churchill Livingstone McRae, Ronald .& Esser, Max., Practical Fracture Treatment. Edinburgh: Churchill Livingstone Pandey, Sureswar .& Pandey, Anilkumar., Clinical Orthopaedic Diagnosis .New Delhi: Jaypee Brothers. Maher,Ann.B,Susan.W.Salmond &Teresa.A.Pellino.Orthopedic Nursing.W.B.Saunders. Powell Mary.Orthopedic Nursing & Rehabilitation.W.B.Saunders. R.M.Kirk.General Surgical Operations.Vth Edition,Elsevier. Ignatavicius ,Donna D.Medical-Surgical Nursing5th edn.Elsevie. Smeltzer ,Suzanne.C Brunner and Suddarths Text book of Medical surgical Nursing.11th edn :Lippincott. Lewis. Medical Surgical Nursing Assessment & Management of Problems, 7th Edn. Mosby Publishers. Joyce M Black. Medical Surgical Nursing-Clinical Management for positive outcomes, 7th Edn. Saunders, Mossouri. Note: * Latest Edition

153

CLINICAL SPECIALITY - II MEDICAL SURGICAL NURSING - GASTRO ENTEROLOGY NURSING

Placement : II Year Hours of Instruction Theory : 150 hrs.

Nursing Faculty:-110hrs External Faculty:-40hrs Practical : Total : Course Description This course is designed to assist students in developing expertise and in-depth understanding in the field of gastro enterology Nursing. It will help students to develop advanced skills for nursing intervention in various gastro enterology conditions. It will enable the student to function as gastro enterology nurse practitioner/specialist and provide quality care. It will further enable the student to function as educator, manager, and researcher in the field of gastro enterology nursing. Objectives At the end of the course the students will be able to 1. 2. Appreciate trends and issues related to gastro enterology Nusing Describe the epidemiology, etiology, pathophysiology and diagnostic assessment of gastrointestinal conditions. 3. Participate in national health programmes for health promotion, prevention and rehabilitation of patients with gastrointestinal conditions. 4. 5. 6. 7. Perform physical, psychosocial & spiritual assessment. Assist in various diagnostic, therapeutic and surgical procedures. Provide comprehensive care to patients with gastrointestinal conditions. Describe the various drugs used in gastrointestinal conditions and nurses responsibility. 8. Demonstrate skill in handling various equipments/gadgets used for patients with gastrointestinal conditions. 9. Appreciate team work & coordinate activities related to patient care. 1450 hrs. 1600 hrs.

10. Practice infection control measures. 11. Identify emergencies and complications & take appropriate measures.

154

12. Assist patients and their family to cope with emotional distress, grief, anxiety and spiritual needs. 13. Discuss the legal and ethical issues in Gastro Enterology nursing. 14. Identify the sources of stress and manage burnout syndrome among health care providers. 15. Appreciate the role of alternative system of medicine in care of patient. 16. Incorporate evidence based nursing practice and identify the areas of research in the field of gastrointestinal nursing. 17. Teach and supervise nurses and allied health workers. 18. Design a layout of Gastro entrology intensive care unit (GEICU) , liver care/transplant unit.

Course Content UNIT I HOURS 5 Introduction Historical development: trends and issues in the field of gastroenterology. Gastro enterological problems Concepts, principles and nursing perspectives Ethical and legal issues Evidence based nursing and its application in gastrointestinal nursing(to be incorporated in all the units) II 5 Epidemiology Risk factors associated with GE conditions- Hereditary, Psychosocial factors, smoking, alcoholism, dietary habits, cultural and ethnic considerations. Health promotion, disease prevention, life style modification and its implications to nursing. National health programmes related to gastro enterology. Alternate system of medicine/complementary therapies. III 5 Review of anatomy and physiology of gastrointestinal system Gastrointestinal system Liver, biliary and pancreas Gerontologic considerations
155

CONTENT

 Embryology of GI system Immunology specific to GI system. IV 15 EF5 Assessment and diagnostic measures History taking Physical assessment, psychosocial assessment Diagnostic tests Radiological studies:Upper GIT- barium swallow, lower GIT- Barrium enema, Ultra sound: Computed tomography MRI Cholangiography: Percutaneous transheptatic Cholangiogram(PTC) Magnetic Resonance Cholangio pancreotography (MRCP) Nuclear imaging scans(scintigraphy) Endoscopy Colonoscopy Proctosigmoidoscopy Endoscopic Retrogrde Cholongio pancreotography (ERCP) Endoscopic ultrasound Peritonoscopy(Laproscopy) Gastric emptying studies Blood chemistries: Serum amylase, serum lipase Liver biopsy Miscellaneous tests: Gastric analysis, fecal analysis Liver function tests: Bile formation and excretion, dye excretion test, Protein metabolism, haemostatic functions- prothrombin, vitamin K production, serum enzyme tests, Lipid metabolismserum cholesterol Interpretation of diagnostic measures Nurses role in diagnostic tests
156

25 EF10

Gastro intestinal disorders and nursing management Etiology, clinical manifestations, diagnosis, prognosis, related pathophysiology, medical , surgical and nursing management of Disorders of the mouth: Dental caries, Peridontal disease, Acute tooth infection, Stomatitis, Thrush (moniliasis),Gingivitis, Leukoplakia, Inflammation of the parotid gland, Obstruction to the flow of saliva, Fracture of the jaw. Disorders of the oesophagus: Reflux oesophagitis, Oesophageal achalasia, Oesoophageal varices, Hiatus hernia, Diverticulum. Disorders of the stomach and duodenum: Gastritis, Peptic ulcer, Dumping of the stomach, Food poisoning, idiopathic gastroparesis, Aerophagia and belching syndrome, Ideopathic cyclic nausea and vomiting, Rumination syndrome, Functional dyspepsia, Chronic on specific (functional) abdominal pain. Disorders of the small intestine - Malabsorption syndrome tropical sprue - Gluten sensitive enteropathy (Coeliac disease) - Inflammatory diseases of intestines and abdomen,: appendicitis, Peritonites, Intestinal obstruction, Abdominal TB, Gastrointestinal polyposis syndrome - Chronic inflammatory bowel disease, Ulcerative colitis, crohns disease - Infestations and infections Worm infestations, Typhoid, Leptospirosis - Solitary rectal ulcer syndrome - Alteration in bowel elimination (diarrhoea,
constipation, fecal impaction, fecal incontinence, Irritable bowel syndrome, Chronic idiopathic 157

constipation, Functional diarrhea

Anorectal Conditions: Hemorrhoids, Anal fissure, Anal fistula, Abscess, Strictures, Rectal prolapse, Pruritis ani, Pilonidal disease, Anal condylomas, Warts VI 15 EF10 Disorder of liver, pancreas gall bladder and nursing management Disorders of liver biliary tract Viral Hepatitis A, B, C, D & E Toxic hepatitis Cirrhosis of liver, liver failure, Liver transplantation Non cirrhotic portal fibrosis Liver abscess,; Parasitic and other cysts of the liver

Disorders of the Gall Bladder and Bile Duct: Cholecystitis, Cholelithiasis and Choledocholilethiasis Disorders of the pancreas: Pancreatitis, Benign tumors of islet cells Disorders of the Peritoneum. Infections of the peritoneum - Surgical peritonitis - Spontaneous bacterial peritonitis - Tuberculosis peritonitis Disorders of the Diaphragm. -

Diaphragmatic hernia Congenital hernias Paralysis of diaphragm Tumors of the diaphragm Hiccups

VII

15 EF5

Gastro intestinal emergencies and nursing interventions Etiology, clinical manifestations, diagnosis, prognosis, related pathophysiology, medical , surgical and nursing management of:
158

 Esophageal varices Ulcer perforation Acute cholecystitis Diverticulitis Fulminant hepatic failure Biliary obstruction Bowel obstruction Gastroenteritis Intussusception Acute intestinal obstruction, perforation Acute pancreatitis Cirrhosis of liver complications Liver , spleen, stomach pancreatic, mesenteric, bowel and greater vessel injuries Acute appendicitis /peritonitis Acute abdomen Food poisoning VIII 15 EF5 o Congenital Anomalies of Esophagus Esophageal atresia Tracheo esophageal fistula Esophageal stenosis Esophageal duplications Dysphagia Lusoria aberrent right subclavian artery compressing esophagus Esophageal rings schalzki ring Esophageal webs o Congenital Anomalies of Stomach Gastric atresia Micro gastria Gastric diverticulum Gastric duplication Gastric teratoma Gastric volvulus
159

 Infantile hypertrophic pyloric stenosis Adult hypertrophic pyloric stenosis o Congenital Anomalies of Duodenum Duodenal Atresia or stenosis Annular pancreas Duodenal duplication cysts Malrotation and mid gut volvolus o Developmental anomalies of the intestine: Abdominal wall defects (omphalocele and Gastroschisis) Meckels diverticulum Intestinal atresia o IX 15 Hirschsprungs disease Drugs used in GIT Principles of administration Roles responsibilities of nurses Drugs in Peptic ulcer disease Proton Pump inhibitors H2 Receptor Antagonists Cytoprotective Agents Drugs used in Diarrhea Drugs used in constipation Drugs used in Inflammatory Bowel Disease, Aminosalicylates Corticosteroids Immunomodulators Chemotherapy Antibiotics Antiemetics Anticholinergics Antihistaminics Antihelminthics Vitamin Supplements. X 10 Nutrition and nutritional problems related to GI system
160

Pharmo Kinetics

 Nutritional assessment and nursing interventions Therapeutic diets Adverse reactions between drugs and various foods. Malnutrition- etiology , clinical manifestations and management Tube feeding, parenteral nutrition, total parenteral nutrition Obesity- etiology, clinical manifestations and management Eating disorders- anorexia nervosa, bulimia nervosa Recent advances in nutrition XI 15 EF5 Malignant disorders of gastro intestinal system o Etiology, clinical manifestations, diagnosis, prognosis, related pathophysiology, medical , surgical, other modalities and nursing management of: Malignancy of oral cavity, Lip, Tongue, buccal mucosa, oropharynx, Salivary gland. Esophageal , Gastric , Carcinoma of bowel - Small bowel, Colorectal and Anal carcinoma, Liver, biliary tract and Pancreatic carcinoma XII 5 Administration and management of GE unit Design & layout Staffing Equipment, supplies Infection control; Standard safety measures. Quality Assurance:-Nursing audit records /reports, Norms, policies and protocols Practice standards. XIII 5 Education and training in GE care o Staff orientation, training and development o In-service education program Clinical teaching programs.

Practicals Total = 1450 Hours

161

1 Week =48 Hours SL. No 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Dept/ Unit Diagnostic Lab Emergency & Casualty Liver Transplant Unit GE Medical Ward GE Surgical Ward OT ICU Pediatric Gastroenterology Oncology GE OPD Total No .of Weeks 1 2 1 6 8 2 4 2 2 2 30

Internal Assessment Theory weightage Sessional exams -3 Written assignments Seminars/Presentations Total Procedures to be assisted 1. Endoscopy room Upper G.I. Endoscopy (Diagnostic and therapeutic). 2. Sigmoidoscopy 3. Colonoscopy 4. Polypectomy 5. Endoscopic retrograde cholangio pancreatography (ERCP) 6. Liver biopsy 7. Percutaneous catheter drainage (PCD) of Pseudocyst pancreas 8. Abdominal paracentesis 9. Percutaneous aspiration of liver abscess 10. GE Lab : PT, HbsAg, Markers A, B, C virus, CBP, ESR, Stool Test Procedures to be performed 1. History and Physical assessment 2. RT intubation / extubation / aspiration/suction 3. Gastric lavage and gavage 4. Bowel wash 5. Therapeutic Diets
162

50% 25% 25% 100%

Practical weightage Ongoing assessment Clinical assignments Internal examination TOTAL

50% 30% 20% 100%

6. Ostomy feeding 7. Stoma care 8. Monitoring vital parameters 9. Plan of inservice education programme for nursing staff and Class-IV employees 10. Counseling REFERENCES * : Sherlock Sheila . Diseases of liver and biliary system, 8th edn Blackwell Scientific Publications. Dr. Reddy. D . Nageshwar & Dr Rao G.V . Manual of therapeutic GI Endoscopy, Paras Medical Publishers. Townsend. M. Courtney et al. Sabiston Textbook of Surgery, The Biological Basis of Modern Surgical Practice, 18th edn, Saunders Co Faunci.S . Anthony. Harrisons principles of Internal Medicine, 14th edn, Mc Grow Hill Health Professions Divisions Company. Reed . B. Joanne, Quick R.G. Clive and Burkitt George H Essential Surgery Problems, Diagnosis And Management, 4th edn, Churchill Livingstone Company Pounder R.E. Recent Advances in Gastroenterology Churchill Livingstone Company Tandon B. N. Tropical Hepato Gastro enterology Elsevier India Pvt Ltd Floch .H . Martin et al Netters Gastroenterology, International Student Edition, ICON Learning System, U.S.A Feldman, M Friedman L , Sleisinger,. M Sleisinginer & Fordtrans gastrointestinal and Liver disease: pathophysiology, Diagnosis and Management. Saunders. Caroll Lutz & Karen Pozytulski. Nutrition and Diet Therapy. Jaypee Mahan L Kathelene & Sylvia Escott-Stump. Krauses Food and Nutrition Therapy. Saunders. Smeltzer ,Suzanne.C Brunner and Suddarths Text book of Medical surgical Nursing.11th edn :Lippincott. Lewis. Medical Surgical Nursing Assessment & Management of Problems, 7th Edn. Mosby Publishers. Joyce M Black. Medical Surgical Nursing-Clinical Management for positive outcomes, 7th Edn. Saunders, Mossouri.

Note: * Latest Edition

163

CLINICAL SPECIALTY II CHILD HEALTH (PAEDIATRIC) NURSING-II

Placement : II Year Hours of Instruction Theory 150 hours External 50 hours Internal 100 hours Practical 1450 hours Total : 1600 hours

Course Description

This course is designed to assist students in developing expertise and in-depth understanding in the field of Child Health Nursing. It will help students to develop advanced skills for nursing intervention in various pediatric medical and surgical conditions. It will enable the student to function as pediatric nurse practitioner/specialist. It will further enable the student to function as educator, manager, and researcher in the field of Child Health Nursing

Objectives At the end of the course the students will be able to: 1. Apply the nursing process in the care of ill infants to adolescents in hospital and Community. 2. Demonstrate advanced skills/competence in nursing management of children with medical and surgical problems. 3. 4. 5. 6. Recognize and manage emergencies in children. Provide nursing care to critically ill children. Recognize and manage emergencies in neonates. Identify various treatment modalities in the management of high risk neonates/children. 7. Prepare a design for layout and describe standards for management of pediatric units/hospitals. 8. Identify areas of research in the field of Child Health Nursing.
164

COURSE CONTENT Unit Hours Content I 5 Introduction Current & Future role of pediatric nurse in various settings -Expanded and Extended II 60 EF 30 Medical conditions Pathophysiology, assessment(including interpretation of various invasive and non-invasive diagnostic procedures), treatment modalities and nursing intervention in selected pediatric medical disorders Child with respiratory disorders: - Upper respiratory tract: choanal atresia, tonsillitis, epistaxis, aspiration. - Lower respiratory tract: Broncheolitis, Bronchopneumonia, Asthma, croup, cystic fibrosis Child with gastro-intestinal disorders: - Diarrheal diseases, gastro-esophageal reflux. - Hepatic disorders: Hepatitis, Indian childhood cirrhosis, Wilsons disease, Reyes Syndrome, Celiac Disease - Malabsorption syndrome, Malnutrition,Deficiency disorders Child with renal/ urinary tract disorders: Nephrotic syndrome, Nephritis, Hydronephrosis, hemolytic-uremic syndrome, ARF Child with cardio-vascular disorders: - Acquired: Rheumatic fever, Rheumatic heart disease, Kawasakis disease, Cardiomyopathy - Congenital: Cynotic and acynotic Child with endocrine/metabolic disorders: Diabetes insipidus, Diabetes Mellitus hyper and hypo thyroidism, inborn errors of metabolism Child with Neurological disorders: seizure disorders Meningitis, encephalitis, Guillian- Barre syndrome, Reyes syndrome Child with oncological disorders: Leukemias, Lymphomas, Wilms tumor, neuroblastomas, Rhabdomyosarcoma, retinoblastoma, hepatoblastoma, bone tumors, brain tumors Child with blood disorders: Anemias, thalassemias,
165

hemophilia, polycythemia, thrombocytopenia, and disseminated intravascular coagulation Child with skin disorders: scabies, staphylococeal scalded skin syndrome, vascular lesions Common Eye and ENT disorders congenital malformations, otitis media Common Communicable diseases: TB, Polio, Diptheria, pertusis, tetanus, chicken pox, measles, mumps, rubella, HIV/AIDS, H1N1, Chikkun gunia, leptospirosis, dengue, IMN III 50 EF 20 Surgical conditions Assessment(including interpretation of various invasive and non-invasive diagnostic procedures), treatment modalities including cosmetic surgery and nursing interventions in selected pediatric surgical problems/ Disorders Gastrointestinal system: Cleft lip, cleft palate and conditions requiring plastic surgery, Tracheo esophageal fistula/atresia, Hirschsprungs disease/megacolon, malrotation, intestinal obstruction, duodenal atresia, pyloric stenosis, gastrochisis, exomphalus, anorectal malformation, omphalocele, diaphragmatic hernia Anomalies of the nervous system: Spina bifida, Meningocele, Myelomeningocele, hydrocephalus Anomalies of the genito-urinary system: Hypospadias, Epispadias, Undescended Hydronephrosis, Anomalies of the skeletal system Talipus, Hip dislocation Nursing management of the child with traumatic injuries: General principles of managing Pediatric trauma - Head injury, abdominal injury, poisoning, foreign body obstruction, burns - Bites & Stinges Organ transplantation Liver Kidney Management of stomas, catheters and tubes
166

testes,

Exstrophy

bladder

Obstructive

uropathy,

 Management of wounds and drainages IV 20 Intensive care for pediatric clients Resuscitation, and post resuscitation management Care of critically ill child physical, physiological, psychological Legal and ethical issues in pediatric intensive care Intensive care procedures, central line, intra osteus, endotracheal intubation, tracheostomy care, peritoneal dialysis Documentation- ICU flow sheet V 10 Administration and management of pediatric care unit Design & layout Staffing, Equipment, supplies, Norms, policies and protocols Practice standards for pediatric care unit Organization of neonatal care, services(Levels), transport, neonatal intensive care unit, organization and management of nursing services in NICU Documentation VI 5 Education and training in Pediatric care Staff orientation, training and development, In-service education program, Clinical teaching programs. Practical Total = 1450 Hours 1 Week = 48 Hours Sl.No 1. 2. 3. 4. 5. 6. 7. Dept/ Unit Pediatric Medical I.C.U Pediatric Surgical I.C.U NICU Pediatric OT Pediatric Medical Ward Pediatric Surgical Ward Emergency/ Casualty Total No. Of Weeks 4 5 2 3 5 5 6 30
167

Theory weightage Sessional exams (30) Written assignments Seminars TOTAL 50% 25% 25% 100%

Practical weightage Ongoing assessment Clinical assignments Internal examination TOTAL 40% 40% 20% 100%

Essential I. Procedures to be Observed: Echo cardiogram Ultrasound ROP screening (Retinopathy of prematurity) Any other II. Procedures to be Assisted Advanced neonatal life support Lumbar Puncture Arterial Blood Gas ECG Recording III. Procedures to be Performed: Airway Management - Application of Oro Pharyngeal Airway - Oxygen therapy - CPAP(Continuous Positive Airway Pressure) - Care of Tracheostomy - Endotracheal Intubation Neonatal Resuscitation Monitoring of Neonates clinically & with monitors, CRT(Capillary Refill Time), assessment of jaundice Gastric Lavage Assignments Clinical presentations Clinical teaching Patient care profile

IV. REFERENCES
168

 Avery,Fletcher

and

Mac

Donald

(1999).

Neonatology-

Pathophysiology,

Management of Newborn 5th edn. Lippincott Co. Behrman, Klieg man & Jenson (2004) Nelson Textbook of Paediatrics 18 th edn. Edwards, Hertzberg, Haya & Youngblood( 1999). Pediatric Rehabilitation Nursing, W.B Saunders Co. Ghai,Piyush and Paul (2006). Practical Paediatrics. 6th edn.CBS Publishers, New Delhi. Gupte, S.(2004). The Short Textbook of Paediatrics. 10th edn.Jaypee Brothers. Hockenbery, Wilson, Winlelstein & Kline(2004). Wongs Nursing Care of Infants and Children.7th edn.Elsevier. Johnston, G.B (2000). The newborn Child- 9th edn. Churchill Livingstone. Joshi, N.C.(2007). Clinical Paediatrics. Elsevier Pvt. Ltd. Kulkarni, M.L (2005). Clinical Methods in Paediatrics- Physical examination of children. Vol.1,2,&3, Jaypee brothers. Lissauer & Clayden (2007). Illustrated Textbook of Paediatrics. 3rd .edn. Marlow & Redding (2008). Textbook of Pediatric Nursing.6th edn. Saunders. Co. Robertson D.M & South, M(2000). The newborn Child- 9th edn.Churchill Livingstone. Skale, N.(1999). Manual of Pediatric Nursing Procedures. J.B. Lippincott Co. Williams ,C & Asquith, J.(20000. Paediatric Intensive Care Nursing. 2nd Edn. Churchill livingstone Wong, D.L (2005).Whaley & Wongs Nursing care of Infants and Children 7th Edn.Mosby Co. Wong, D.L (2005).Whaley & Wongs Essentials of Pediatric Nursing. 8th edn. Mosby Co.

***********

169

CLINICAL SPECIALTY-1I MENTAL HEALTH (PSYCHIATRIC) NURSING-1I

Placement- II Year Hours of Instruction Theory -150 Hrs Practical -1450 Hrs. Total -1600 Hrs. Resource. Persons Psychiatric Nursing Faculty-100 Hrs Psychiatrist -30 Hrs Psychologist -10 Hrs Psychiatric social worker-10 Hrs

Course Description: The course is designed to develop in depth knowledge in advanced concepts in psychiatry and psychiatric nursing and apply this knowledge in rendering comprehensive care to clients in different settings by collaborating psychiatric nursing with other disciplines and to assume expanded roles as nurse therapist, counselor educator, administrator and researcher in various settings. Objectives: 1. Demonstrate advanced skills and competence in nursing management of patients with mental disorders in various settings. 2. Identify and care for special groups like children, adolescents, women, elderly abused and neglected, people living with HIV/AIDS. 3. Identify and manage psychiatric emergencies 4. Provide nursing care to critically ill patients with mental disorders. 5. Utilize the recent technology and various treatment modalities in management of patients with mental disorders. 6. Demonstrate skills in carrying out crisis intervention. 7. Incorporate evidence based nursing practices and identify the areas of research in the field of psychiatric nursing. 8. Prepare, design and layout for psychiatric units/emergency units. 9. Teach psychiatric nursing to undergraduate students. 10. Plan and organize in service education programmes in psychiatric nursing.
170

UNIT I

TIME (HRS) 10

CONTENT CRISIS INTERVENTION Crisis: definition, types, phases. Crisis Intervention strategies Prevention of crises. Role of crisis intervention Effects of disaster, war violence, terrorism, trauma in individuals and group. Post traumatic stress disorder(PTSD)

II

15 (Psychi-5)

PSYCHIATRIC EMERGENCIES Common psychiatric emergencies and management. The Suicidal Client Epidemiological factors Risk factors Predisposing factors: theories of suicide, biological, psychological, sociological Nursing management

III

5 (Psychi-5)

MEDICAL CONDITIONS DUE TO PSYCHOLOGICAL FACTORS Asthma Coronary heart disease Cancer peptic ulcer Essential hypetension Migraine head ache Rheumatoid arthritis Ulcerative colitis Treatment and nursing management

IV

10

SOMATOFORM AND SLEEP DISORDERS Somatoform Disorders Historical aspects Epidemiology Pain disorders
171

Hypochondriasis Conversion disorders Body dysmorphic disorders

Sleep Disorders Treatment modalities and nursing management V 5 DISSOCIATIVE DISORDERS AND MANAGEMENT VI 5 VII 5 VIII 5 IX 15 (Psychi-5) Historical aspects Epidemiological factors Treatment modalities and nursing management

SEXUAL AND GENDER IDENTITY DISORDERS Development of human Sexuality Sexual Disorders Variation in sexual orientation Treatment and nursing management

EATING DISORDERS Epidemiological factors Predisposing factors: Anorexia Nervosa Bulimia Nervosa and obesity Psychopharmacology Treatment and nursing management

ADJUSTMENT AND IMPULSE CONTROL DISORDERS Epidemiological factors Adjustment disorders Impulse Control Disorders Treatment and nursing management

PERSONALITY DISORDERS Epidemiological factors Types of Personality Disorders Paranoid Personality Disorder Schizoid Personality Disorder Antisocial Personality disorder Borderline Personality Disorder Histrionic Personality Disorder
172

 X 20 (Psychi.10)

Narcissistic Personality Disorder Avoidance Personality Disorder Dependent Personality Disorder Obsessive -compulsive Personality Disorder Passive -Aggressive Personality Disorder

Identification, diagnosis, symptoms Psychopharmacology Treatment and nursing management

DISORDERS OF INFANCY, CHILDHOOD, AND ADOLESCENCE Review of theories of child and adolescent development Psychiatric illness in children and adolescents- concepts General response Mental retardation Predisposing factors Management Prevention Rehabilitation Autistic disorders Attention deficit hyper active disorders Tourettes disorders Separation anxiety disorders Conduct Disorders Mixed Disorders of conduct and emotion Disorders of social functioning with onset specific to childhood and adolescence. Tic disorders Other emotional and behavioural disorders with onset usually occurring in childhood and adolescence.

XI

10 (Psychi-5)

GERIATRIC MENTAL HEALTH Theories of ageing Biological, psychological, and socio-cultural aspects of ageing
173

 XII 5 (Psycho.) XIII 5 (Psycho-5) XIV 10 (PSW-5H)

Special concerns of elderly population. Psychiatric problems among elderly population. Treatment and nursing management. Rehabilitation

WOMEN AND MENTAL HEALTH Psychological problems related to menstruation, menopause, conception, pregnancy and puerperium. Counseling- premarital, marital, and genetic Other psychosocial problems.

CLIENT WITH HIV/AIDS Psycho- social problems of clients with HIV/AIDS Counseling Nursing management

COMMUNITY MENTAL HEALTH NURSING Concepts and models of community mental health The community as Client o Primary Prevention o Populations at Risk o Secondary prevention o Tertiary Prevention The Role of the Nurse National Mental Health programme (NMHP) District Mental Health Programme (DMHP) Community mental health centers: organization and functions.

XV

CLIENTS WITH LIFE THRETENING ILLNESSNESS Loss and bereavement Stages of grief and grief response Adaptive and mal adaptive response to grief Psychosocial concerns of clients and families with life threatening and debilitating illnesses Nursing management

174

XVI

PROBLEMS RELATED TO ABUSE , VIOLENCE AND NEGLECT Vulnerable groups, Women, Children, elderly, psychiatric patients, under privileged, differentially able. Prevention and management Counseling

XVII

5 (PSW)

PSYCHOSOCIAL REHABILITATION Principles of rehabilitation Disability assessment Community based rehabilitation o Day care centers o Half way homes o Sheltered workshops o Correctional homes o Self help groups Training and support to care givers Role of nurse

XVIII

ADMINISTRATION AND MANAGEMENT OF PSYCHIATRIC UNITS INCLUDING EMERGENCY UNITS Design & layout Planning, equipment, staffing and budgeting Norms, policies and protocols for management of psychiatric patients in different settings Quality assurance Documentation

XIX

EDUCATION AND RESEARCH IN PSYCHIATRIC CARE In-service education programmes Clinical teaching programs. Scope, problems, and future perspectives of research in psychiatric nursing Evidence based practice

175

PRACTICAL Total -1450 Hours AREA OF POSTING Acute psychiatric ward Chronic psychiatric ward De- addiction unit Psychiatric emergency unit OPD Child psychiatric unit and child guidance clinic Family psychiatry Filed visits Rehabilitation/ occupational therapy Community mental health In-service education programme Total NO. OF WEEKS 4 4 2 4 3 2 2 2 2 4 1 30

SL NO 1 2 3 4 5 6 7 8 9 10 11

*NIMHANS, Bangalore -8 weeks posting to be included in the area of posting STUDENT ACTIVITIES History taking Mental Status Examination Nursing care plan Psycho education Case presentation Case study - Weekly one - Weekly one - Weekly one -1 -4 -2

Participating in various therapies Phramco therapy, ECT, Social/recreation therapy Family therapy Group therapy Counseling Cognitive Behavioral therapy Project work based on community care setting Field visits Play therapy

176

Method of Evaluation Theory Sessional examinations 3 Seminar Term paper 1 Total Practical Ongoing clinical evaluation Clinical assignments Project Internal practical examination Total 30 % 20 % 20 % 30 % 100% Weightage 50 % 25 % 25 % 100%

REFERENCES: Kaplan and Sadock, Comprehensive Text Book of Psychiatry, Latest Edition, William And Wilkins Co. Baltimore. Gelder, Mayor and Cowen, Shorter Oxford Textbook of Psychiatry, Latest Edition, Oxford University Press. Krupnick Susan L.W. and Wade Andrew, Psychiatric Care Planning-Now with Clinical Pathways, Latest Edition, Springhouse Corpn, Pennsylvania. Wilson & Kneisl, Psychiatric Nursing, Latest Edition-Addison Wesly, a Division of Bengamin/Cummings publishing co,INC Burgess Wolbert Ann, Advanced Practice, Psychiatric Nursing, Latest Edition, Appleton & Large, Stanford, Connecticut Janosik & Davis, Mental Health & Psychiatric Nursing, Latest Edition, Little, Brown & Company. Boston. Varcarolis Elizabeth. M, Foundations of Psychiatric Mental Health Nursing, Latest Edition, W.B.Saunders Company.Philadelphia. Carson & Arnold, Mental Health Nursing-The Nurse Patient Journey, Latest Edition, W.B.Saunders Company. Philadelphia. Stuart & Lararia, Stuart& Sundeens Principles & Practice of Psychiatric Nursing, Latest Edition, Mosby Company

177

 Andrew Sims CP, An Introduction to Descriptive Psychopathology, Latest Edition, W. B. Saunders Company. Philadelphia. Barbara Schoen Johnson, Adaptation &Growth- Psychiatric Mental Health Nursing, Latest Edition, Lippincott. WHO.ICD 10 Classification of Mental & Behavioural Disorder Shaffer David R. Developmental Psychology: Childhood & Adolescence, Brookes/Cole publishing Co, Pacific Grove. Wiener Jerry M(Editor), T.B of Child & Adolescent Psychiatry, American academy of child & adolescent Psychiatry, American Psychiatric Press. Otong Deborah Antai, Psychiatric Nursing : Biological & Behavioral concepts, Thomson Delmere Learning, Canada. Boyd Mary Ann, Psychiatric Nursing: Contemporary Practice, Lippincott Williams & Wilkins, New York. Redferrin Sally J & Ross Fiona M (Editors), Nursing Older People, Churchill Livingstone, Edinburgh. Lego Suzanne, Psychiatric Nursing: A Comprehensive Reference, Lippincott, Philadelphia. Shea A etal, Advanced Practice Nursing: Psychiatric & Mental health care, Mosby, St: Louis. Lueckenotte AG. Gerontologic nursing, Mosby, St: Louis. Note:-* Latest Edition

*********

178

CLINICAL SPECIALITY II OBSTETRIC AND GYNAECOLOGICAL NURSING-II

Placement : II year Hours of Instruction Theory:150 hours External- 50 hours Internal- 100 hours Practical: 1450 hours Total:1600Hours. COURSE DESCRIPTION

This course is designed to assist students in developing expertise and in depth understanding in the field of Obstetric and Gynaecological Nursing. It will help the student to develop advanced nursing skills for nursing interventions in various obstetrical and gynaecological conditions. It will further enable the students to function as midwifery nurse practitioner/specialist, educator, manager and researcher in the field of obstetric and gynecological nursing.

Objectives At the end of the course the student will be able to: 1. Describe the epidemiology, etiology, pathophysiology and diagnostic assessment of women with obstetric and gynaecological conditions. 2. Demonstrate competence in caring for women with obstetrical and gynaecological conditions 3. Demonstrate competence in caring for high risk newborn. 4. Identify and manage obstetrical and neonatal emergencies as per protocol 5. Practice infection control measures 6. Utilize recent technology and various diagnostic, therapeutic modalities in the management of obstetrical, gynaecological and neonatal care 7. Demonstrate skill in handling various equipments/gadgets used for obstetrical, gynaecological and neonatal care 8. Teach and supervise nurses and allied health workers 9 .Design a layout of specialty units of obstetrics and gynaecology

10 .Develop standards for obstetrical and gynaecological nursing practice.

179

11 .Counsel women and families 12. Incorporate evidence based nursing practice and identify the areas of field of obstetrical and gynaecological nursing 13. Function as independent midwifery nurse practitioner Unit I Hours 25 EF8 Content Management of problems of women during pregnancy Risk approach- obstetrical nursing care concepts & goals Screening of high-risk pregnancy, newer modalities of diagnosis. Nursing management of high risk pregnancies II 15 EF8 Pernicious Vomiting Bleeding in early pregnancy, abortion, ectopic pregnancy, and gestational trophoblostic diseases. Bleeding during late pregnancy: antepartum hemorrhageplacenta praevia, abruptio placenta Hypertensive disorders in pregnancy-Gestational hypertention, pre-eclampsia, eclampsia,) Iso-immune disease, Rh & ABO incompatibility Hematological problems in pregnancy Hydramnios , oligohydramnios Prolonged pregnancy-post term, post maturity Multiple pregnancy. Intra uterine growth retardation (IUGR), Premature Rupture of Membrane(PROM). Intra uterine death,Loss, grief & bereavement. research in the

Pregnancies at risk-due to pre-existing health problems Diabetes Mellitus Anemia and nutritional deficiencies Hepatitis Cardio-vascular disease Thyroid diseases Epilepsy Haematological disorders Chronic renal failure Tropical diseases
180

 Psychiatric disorders InfectionsToxoplasmosis, Rubella, Cytomegalo virus, Herpes

(TORCH), STD, HIV/AIDS, vaginal infections, Leprosy, Tuberculosis. Other risk factors: Age-Adolescents, elderly; unwed mothers, sexual abuse, substance use. Pregnancies complicating with tumors, uterine anomalies, prolapse, ovarian cyst. III 20 EF10 Abnormal labour, & obstetrical emergencies Etiology, pathophysiology and nursing management of Uncoordinated uterine actionsAtony of uterus, Preterm

labour,precipitate labour, prolonged labour Abnormal presentations. Contracted pelvis-CPD; dystocia Obstetrical emergencies- obstetrical shock, vasa praevia, inversion of uterus, amniotic fluid embolism, rupture uterus, cord presentation and prolapse cord. Medical and surgical induction Obstetrical operation: Forceps delivery, Ventouse, Caesarian section, Destructive operations Genital tract injuries-Perineal tear, VVF, RVF Complications of third stage of labour: IV 15 EF5 Post partum Hemorrhage Retained placenta, adherent placenta Manual removal of placenta Critical care in obstetrics- role of the nurse

High risk Puerperium Nursing management of Puerperal infections, puerperal sepsis, urinary complications,venous thrombosis, Thrombophlebitis and pulmonary embolism. Sub involution of uterus Breast complications. Psychological complications-Postpartum blues, depression,
181

psychosis. V 25 EF8 High Risk Newborn - Concept, goals, assessment, principles. - Nursing management of Pre-term, small for gestational age, post-mature infant and baby of diabetic and substance use mothers. Respiratory complications; Asphyxia neonatorum, neonatal apnoea, meconium mediastinum. Icterus neonatorum. Birth injuries. Hypoxic ischaemic encephalopathy. Congenital anomalies. Neonatal seizures. Neonatal hypocalcaemia, hypoglycemia, hypomagnesaemia. Neonatal heart diseases. Neonatal hemolytic diseases. Neonatal infections, neonatal sepsis, opthalmia neonatorum. aspiration syndrome, pneumo thorax, pneumo

Congenital syphilis, HIV/ AIDS. Hematological conditions erythroblastosis fetalis, hemorrhagic disorders in newborn. Organization of neonatal care, services (Levels), transport, neonatal intensive care unit, organization and management of nursing services in NICU VI 15 EF4 Advanced neonatal procedures. Calculation of fluid requirements

HIV / AIDS HIV positive mother and her baby Epidemiology Screening Parent to child transmission (PTCT) Prophylaxis for mother and baby Standard safety measures
182

 VII 25 EF7

Counseling Breast feeding issues National policies and guidelines Issues: Legal, ethical, psychological and rehabilitation Role of nurse

Gynecological problems and nursing management Gynaecological assessment, Psychosocial factors of gynaecologic care. Gynaecological procedures. Etiology, pathophysiology, diagnosis, and nursing management of - Menstrual irregularities - Menopause - Diseases of genital tract - Endometriosis, Adenomyosis -Displacement of the uterus -Genital prolapse -Uterine malformation-Uterinefibroid, ovariantumors, PID, reproductive tract malignancies, -Hysterectomy-Abdominal and vaginal - Laparoscopic surgery

VIII

Administration and management of obstetrical and gynaecological unit Design and layout Staffing Equipment , supplies, Infection control; Standard safety measures Quality Assurance: Obstetric auditing records / reports, norms, policies and protocols Practice standards for obstetrical and gynaecolgical unit.

IX

Education and training in obstetrical and gynaecological care Staff orientation, training, and development In-service education programme Clinical teaching programs

183

Practical Total = 1450 Hours 1 Week=48 hours Sl.No 1 Dept./Unit Antenatal OPD including infertility clinics/ Reproductive medicine, Family welfare and post partum clinic / PPTCT 2 3 4 5 6 7 8 9 Antenatal Labour Room Post natal ward Obstetric / Gynae Operation Theatre Gynaec Ward Post operative ward Neonatal Intensive Care Unit Community midwifery Total 4 5 5 2 2 6 2 2 30 Weeks 2

Procedures to be observed Ultra sonography MRI

Procedures to be assisted Assisted Reproductive technology procedures. Amniocentesis. Cervical & vaginal cytology. Fetoscopy. Hysteroscopy Surgical diathermy. Cryosurgery. Obstetric & Gynaecological operations Abnormal deliveries Forceps application, Ventouse, Breech High risk cases- 30 Exchange blood transfusion Culdocscopy
184

Cystoscopy Laproscopy Endometrial Biopsy Tubal patent test Chemotherapy Radiation therapy Dilatation & Curettage Hysterectomy- Abdominal, Vaginal Caesarean Section

Procedures to be performed High risk antenatal assessment : 20

High risk intranatal assessment : 20 High risk postnatal assessment High risk new born assessment Pelvic examination Assessment of foetal well being - Biochemical ,biophysical Per Vaginal examination - pregnancy, labour, post partum. : 20 : 20

Medical & Surgical induction Conduct of delivery Episiotomy suturing Postnatal assessment Post natal Counseling High risk new born assessment; physical and neurological Neonatal resuscitation Gastric Lavage of newborn Kangaroo mother care. Feeding technique: naso /orogastric, Total parenteral nutrition. Chest physiotherapy Setting of operation theatre. Pap smear Vaginal smear Insertion of pessaries
185

Insertion of IUD and removal Care of new born in ventilator and incubator Plan and organize in service education programme for staff nurses Critical analysis of selected research studies.

Assignments Nursing care analysis Nursing care studies Antenatal Intranatal Postnatal Newborn Gynaecology Clinical profile Clinical teaching Planned health education Design floor plan of obstetric unit. 5 clinical conditions 10 5 1 5 5

Evaluation Methods Assignments Theory & Practical Exam Ongoing evaluation Record of practical work Theory Weightage Practical Weightage

Tests (3) Assignments Seminars Total

50% 25% 25% 100%

Ongoing evaluation Clinical assignment Int. Practical exam Total

50% 25% 25% 100%

186

References *: Fermando Arias, Shrish N Dutta 2008, 3rd edn, Practical Guide to High risk Pregnancy Delivery, ELSEVIER. Lowdermilk, Perry, Bobak. Maternity Nursing. Mosby, Inc. Sharon, Emily & Trula Mayers .(2002). Foundations of Maternal & Newborn Nursing. W.B..Saunders, Philadelphia. Reeder, Martin, Koniak-Griffin,. Maternity Nursing. Lippincott, Philadelphia. Cunnigham, Mac Donald, Gand, Leveno, Gilstrap, Hankins & Clark. Williams Obstetrics. Prentice Hall International, U.S.A. Adele Pillitter. Maternal & Child Health Nursing. Lippicott, Philadelphia. Ratnam, Bhasker Rao, Arulkumaran. Obstetrics & Gynaecology for Post graduates. Orient Longman Ltd, Chennai. Hacker, Moore. Essentials of Obstetrics & Gynaecology. &Company, Asia PTE Ltd. Guilbert, Harmon,. (2003) .Manual of High Risk Pregnancy. (3rd Ed), Mosby. Edmonds D. Keith,. Dewhursts textbook of Obstetrics 7 Gynaecology for post graduates.(2000). 6th Ed), Blackwell Science Ltd ,U.S.A. B Presannakumari. Post Graduate Gynaecology. Jaypee Brothers. Medical Publishers Pvt Ltd. Dunlop Recent Advances in Obstetrics & Gynaecology. Jaypee Brothers. Dutta. Recent Advance in High Risk Pregnancy. Jaypee Brothers. Zutshi. Problem based Approach in Obstetrics & Gyneacology. Jaypee Brothers. Vasishtha. Essentials of Management of Pregnancy in HIV Infected cases. Jaypee Brothers. Harcourt Brace

Note: * Latest Edition **********

187

CLINICAL SPECIALITY II COMMUNITY HEALTH NURSING - II

Placement II year Hours of Instruction Theory :150hours External:-20hours Internal:-130hours Practical :1450hours Total :1600 hours Course Description This course is designed to facilitate students to gain indepth knowledge and develop skill in the administration and management of community health services. It will further enable students to develop leadership qualities and practice as a community health nurse specialist, educator, researcher and manager. Objectives: On completion of the course student will be able to: 1. 2. 3. 4. Review the health planning in India Explain the administration and organization of health system in India Plan, organize, implement and evaluate community-oriented programs Participate effectively as a team member in the health planning at local, regional, state and national level Apply epidemiological concepts and principles in community health nursing practice Demonstrate leadership qualities in the field of community health nursing Supervise and guide the nursing personnel working in community health settings Demonstrate competencies in guiding undergraduate students in community health nursing specialty Conduct individual and group research projects in the field of community health nursing.

5.

6. 7. 8.

9.

10. Demonstrate competency in providing independent family centered nursing care 11. Teach and supervise community health nurses and allied health workers

188

COURSE CONTENT: Unit Hours I 20 (EF 20) Content Health Planning and Management: Planning, purpose, advantages of planning, planning cycle II 20 Management Types and methods National development planning Health planning in India Health committees and recommendations Planning commission Five year plans National Health Policies Health system in India at centre, state, district and local level Panchayati Raj and rural development Health economics definition, concepts, financing in health care sector Evaluation of health services

Health care delivery system in India: Concept of health care Levels of health care Primary health care integration of primary health care in developing countries HFA concept, Millennium Development Goals Indian public health standards Concept of health promotion Health care delivery system: Urban, rural, national, state, district, CHC, PHC,Referral system. sub centre functions, staffing, patterns of assistance, roles and responsibilities of DPHN Critical review of functioning at different levels, evaluation studies, recommendations and nursing perspectives Alternative systems of medicine Health agencies: NGOs; roles and functioning Intersectoral coordination
189

Public private partnership Challenges of health care delivery system

III

25

National Health Programmes and Health Services in India: Objectives, Organization/manpower/resources. Activities, Goals Review and critique of national health programs and services responsibilities of community health nurse National vector borne diseases control program National filariasis control program National leprosy eradication program Revised national TB control program National program for control of blindness National iodine deficiency disorders control program National mental health program National AIDS control program National cancer control control program RCH I and II Noncommunicable disase programs NRHM Integrated disease surveillance program School health services Adolescent health National family welfare program

IV

15

Occupational Health: Introduction: Trends, issues, definition, aims, objectives, workplace safety Ergonomics and solutions Occupational environment physical, social Occupational hazards for different categories of workers physical, chemical, biological, mechanical, accidents. Occupational diseases and disorders Measures for health promotion of workers; prevention and control of occupational diseases, disability limitation and rehabilitation
190

 V 10 VI 10

Women and occupational health Health education and counseling Violence at workplace Child labour Disaster preparedness and management Legal issues: legislation, labour unions, ILO and WHO

recommendations, factories act, ESI act Occupational health team Role of community health nurse

Community Geriatrics: Concept, trends, problems and issues Aging process and changes Theories of aging Health problems and needs Psycho-physiological stressors and disorders Myths and facts of aging Health assessment Home for aged various agencies Rehabilitation of elderly Care of elderly Elderly abuse Training and supervision of care givers Government welfare measures and programmes for elderly, role of N.G.Os. Roles and responsibilities of geriatric nurse in the community

Community Mental Health Magnitude, trends and issues National mental health program community mental health program The changing focus of care The public health model Case management collaborative care Crisis intervention Welfare agencies
191

 VII 10 VIII 20

Population at risk The community as client Primary prevention Secondary prevention Tertiary prevention Community based rehabilitation Human rights of mentally ill Substance abuse Mentally challenged groups Role of community health nurse

Community Rehabilitation: Introduction: Concepts, principles, trends, issues Rehabilitation team Models, methods Community based rehabilitation Ethical issues Rehabilitation council of India Disability and rehabilitation use of various prosthetic devices Psychosocial rehabilitation Rehabilitation of chronic diseases Restorative rehabilitation Vocational rehabilitation Role of voluntary organizations Guidance and counseling Welfare measures Role and responsibilities of community health nurse

Community Health Nursing Administration and management: Organization of community health nursing practice Design of sub centre, Primary health centre and Community health centre Staffing, supervision and monitoring performance appraisal Leadership and team approach Budgeting
192

Material management Quality assurance standards, protocols, policies and procedures Nursing audit Public relations Documentation and reporting Planning in-service educational programme and teaching Roles and responsibilities of personnel in community health Training of various categories of health workers- preparation of manuals

IX

15

International Health: Global burden of disease Global health rules to halt disease spread Global health priorities and programmes International quarantine Health tourism International co-operation and assistance International travel and trade Health and food legislation International health regulations Migration International health agencies International health issues and problems International nursing practice standards International health vis--vis national health International health days and their significance

Community Oriented Research Need for research in community health nursing Critical review of the selected research studies in community health nursing

PRACTICAL Total = 1450 Hours 1 Week = 48 Hours

193

Sl. No 1 2 3 4

Department/unit

No. of weeks

Urban and rural community Sub centre PHC Participation in all the relevant health programmes Administration of PHC, CHC and District Office

8 weeks 4 weeks 8 weeks 4 weeks

5 6 7

Psychiatric unit and community mental health centers Home for the aged and hospice Community rehabilitation centres and Occupational health unit

2 weeks 1 week 1 week

Rural health training centre

2 weeks

Total Categorization of practical activities Observation Visits MCH office and DPHN Office CHC /First Referral Unit (FRU) Child guidance clinic Institute for mentally challenged District TB centre Community based rehabilitation unit Cancer centers Palliative care Home of old age Community Mental health units De-addiction centers

30 weeks

194

Selected industrial health centers ESI unit Municipality / Corporation office

Assisted activities Laparoscopic sterilization Vasectomy Monitoring of national health and family welfare programmes School health programmes

Activities to be performed Conduct various clinics School health assessment Specific Health survey Health assessment Drug administration as per the Govt. protocols( MDA and Malarial drug administration) Treatment of minor ailments Investigating outbreak of epidemic Screening for leprosy, TB and non-communicable disease Counselling services Report writing- Monthly report of subcentre and PHC Referrals Material management requisition for indent, condemnation, inventory maintenance, Supervision of various categories of personnel Organize one in service education Programmes to JPHN/LHI/LHS Liaison with NGOs

195

Method of Evaluation Theory Sessional examinations (3) Seminars Term paper-1 Total Practical Ongoing clinical evaluation Internal practical examination Clinical Assignments Total 30% 25% 45% 100% Weightage 50 % 25% 25% 100%

References *: Clark M, J. Nursing in the Community, Appleton and Lange, Connecticut, Latest Edn Clemen Stone S, Eigsti D, G. McGuire S, L. Comprehensive Family and Community Health Nursing, Mosby, Latest Edn. Cookfair J, M. Nursing Process and Practice in the Community, Mosby, Latest Edn. Dharr G, M.Robbani I, Foundations of Community Medicine Elsevier, Latest Edn. Gulani K, K. Community Health Nursing:Principles and practices. Latest Edn. Kerr J, Community Health Promotion Tindall, Latest Edn. Loudan, N. Glasier A, Gebbie A Hand book of Family Planning Reproductive Health Care, Churchill Livingstone. Latest Edn. Park, K. Parks Text book of Preventive and Social Medicine, M/S Banarsidas Bhanot Publishers, Latest Edn. Allender J, A. Spardley B, W. Community Health Nursing, Lippincott, Latest Edn. Stanhope M. Lancaster J. Community Health Nursing, C V Mosby Company D.C, Latest Edn. Swarnkar K. Community Health Nursing, Latest Edn.
196

 TNAI. A Community Health Nursing Manual S Kamalam. Essentials of Community Health Nursing Practices. 2nd edn. Jaypee Brothers. New Delhi 2005. Clemen Stone S, Eigsti D G, M C Guire S L. Comprehension Community Health Nurisng. 4th edn. Mosby. Stanhope Marcia. Community and Public Health Nursing-Population centered health. 8th edn. Mosby Publication 2009. Allender, Spardely, Barbara Watton. Commmunity Health Nursing concepts and Practice. Mosby. Macewen-Community based Nursing 2009.Elsevier. Leake-Community Public Health Nursing. Mosby 2009. Elsevier. Ruth B Freeman Textbook of Primary Health Nursing Practices. G M Dhar, I Robbani-Foundations of Community Medicine. Elsevier.

Note:- * Latest Edition

197

Annexure-1

Proforma for Submission of M. Sc Nursing Dissertation Proposal/ Synopsis

1. Name & Address of Student: 2. Email ID of the Student: 3. Registration Number: 4. Name & Address of Recognized Institution: 5. Title of the Dissertation: 6. Name of the Guide: 7. Address, phone number and E-mail ID of the Guide: 8. Educational Qualification of the Guide: 9. Experience of teacher in guiding postgraduate students. (in years): 10. Experience of teacher in guiding M.Phil/Ph.D students if any. (in years): 11. Synopsis of the study: Attached Yes/No

Date:

Signature of the Guide

Enclosures: I.) Bio- Data of the Guide II.) Synopsis of the study (maximum 4-6 pages)
198

Proposal/Synopsis Outline
1. Title 2. Background /significance of the problem. 3. Purpose of the study 4. Statement of the problem 5. Objectives of the study 6. Operational Definitions 7. Conceptual Framework 8. Assumptions/ Hypotheses 9. Research Methodology a) Research Approach b) Research Design c) Setting d) Population,Sample & Sampling Technique e) Tools & Technique f) Pilot Study g) Plan for data collection h) Plan for data analysis 10. Work Plan 11. Budget 12. Ethical Considerations 13. References 14. Appendices Guidelines in writing synopsis The research protocol should be of about 1200 words (4-6 pages of A4 size) on the topic. The research protocol should be submitted with a covering letter signed by the candidate and guide. The work on and writing of protocol/ dissertation should be done under the Guide approved by the University. The guide must be an active P.G teacher and qualified as per INC and the University norms. The synopsis should be signed by the candidate and forwarded through the Guide, Departmental head and Principal of the Institution.

199

KERALA UNIVERSITY OF HEALTH AND ALLIED SCIENCES MEDICAL COLLEGE P.O., THRISSUR 680 596 PROFORMA FOR RECOGNITION OF POST GRADUATE TEACHER [Read the instructions carefully before filling up the proforma] 1. NAME: (in block letters) 2.DATE OF BIRTH: AGE: (Attested copy of SSLC marks card / proof of date of birth to be enclosed) 3. PRESENT DESIGNATION: 4.DEPARTMENT: 5. ADDRESS: COLLEGE ADDRESS Affix Photo

PRESENT ADDRESS

RESIDENTIAL

Phone (o ) : Hospital: Email:

Email: College Fax: Phone ( R ): Mobile: Email:

6. QUALIFICATION: (Attested Xerox copies of all the certificates to be enclosed) Sl No. UG PG M.Phil Ph.D. 7. Teaching Experience Designation Name of the Institution Name of the Degree and Specialization Year of Passing

Name of the University and Place

Apex body recognition

Duration of teaching UG From -- To PG From -- To

Subject / s taught

Total teaching experience Total teaching experience

Before PG______After PG______ Total_____

200

Note: 1. Only full time teaching in a teaching institution affiliated to KUHAS / other universities established by law in India is considered as teaching experience. 2. Attested copies of appointment order, relieving order, service certificate, promotion order & PG degree, Nursing Council registration certificate etc., to be enclosed to claim teaching experience. 3. Qualifications and eligibility for appointment and promotion shall be as per Govt. of Kerala and INC guidelines. 4. Application is to be submitted through proper channel. 5. The envelope should be super scribed as Proforma for Recognition as Post Graduate Teacher. 8. Any other relevant information: (Attach a separate sheet) (Regarding additional qualifications, achievements, publications, awards etc.,) Declaration by the Teacher I hereby declare that the above information provided by me is true and correct. I shall take the sole responsibility for any wrong information provided and liable for any action taken by the university. Place : Date : Signature of the Teacher Endorsement by the Principal The information provided by the teacher is verified from the office records and found to be correct. He/She is eligible to be recognized as a PG teacher to guide the dissertation work of PG students as per the INC regulations. Place : Date : INSTRUCTIONS: 1. The Prescribed Performa must be duly filled by the applicant in his/her own handwriting and submitted to the university through the principals office. 2. The Principal should verify all the informations provided especially the date of birth, qualification, experience, and service details before sending the proforma to the university. 3. Ensure that attested copies of all relevant documents are furnished along with the application. 4. The Principal will be held responsible for any false information provided. 5. Incomplete and incorrect applications and applications with false information will be rejected and they are liable for disciplinary action by the university. Signature of the Principal

201

KERALA UNIVERSITY OF HEALTH AND ALLIED SCIENCES MEDICAL COLLEGE P.O., THRISSUR 680 596 POST GRADUATE DISSERTATION PROFORMA TO BE SUBMITTED FOR CHANGE OF GUIDE (Please Note: Change of guide is permitted only if the guide leaves the college,transferred to another college, retires or dies.) Date: A. Particulars of Candidate, and Existing Guide Candidates Name & Address : Name of the Institution : Course of Study & Subject : Date of Admission to Course : Title of the Topic : Name & Designation of Existing Guide : Signature of the Candidate : B. PARTICULARS OF PROPOSED GUIDE Name & Designation of proposed Guide : Has the proposed guide been recognized as PG teacher by KUHAS: Yes / No If yes, please furnish the particulars of university letter & If No, Please send his/her proforma for recognition as PG teacher Signature of the proposed Guide: Name & Designation of Co-Guide if present: Signature of the Co-Guide:

C: Endorsement for change of guide 1. Remarks and Signature of the HOD : 2. Reason for change of guide: 3. Remarks and Signature of the Principal:
202

Resigned / Retired/ any other

Format for the submission of Dissertation Hard &Soft copy

Instructions to candidates Although your dissertation may be prepared on a computer, consider the following requirements for meeting the standards. Paper Use only one side of high-quality, plain white (unlined in any way) bond paper, minimum 20-lb weight, and 8 x 11 in size. Erasable paper should not be used.

Type Size and Print Select fonts type Times New Roman and a size of 12 characters. The size of the titles should be 14 and Bold, the size of subtitles should be 12 and bold. Print should be letter quality or laser (not dot matrix) printing with dark black characters that are consistently clear and dense. Use the same type of print and print size throughout the document.

Pagination Number all of the pages of your document, including not only the principal text, but also all plates, tables, diagrams, maps, and so on. Roman numerals are used on the preliminary pages (pages up to the first page of text) and Arabic numerals are used on the text pages. The numbers themselves can be placed anywhere on the page, however they should be consistent. Spacing Use double spacing except for long quotations and footnotes which are singlespaced. Margins To allow for binding, the left-hand margin must be 1.5. Other margins should be 1.0. Diagrams, or photographs in any form should be a standard page size, or if larger, folded so that a free left-hand margin of 1.5 remains and the folded sheet is not larger than the standard page. Photographs Professional quality black-and-white photographs are necessary for clear reproduction. Colors are allowed, but you should be certain the colored figure will copy clearly and will not be confusing when printed in black and white.

203

FILE FORMAT Dissertation format should be in .Doc (Ms Word Document) or PDF (Portable Document Format), Image files in JPG or TIFF format and Audio Visual in AVI (Audio Video Interleave), GIF, MPEG (moving picture expert) files format. Labeling on CD CD-ROM Labeling should be standard and should contain title, name of the candidate, degree name, subject name, guide name, name of the department, college, place and year.

References Vancouver style format.

204

<----------------------------Title---------------------------->

by

Name of the Candidate Dissertation Submitted to the KERALA UNIVERSITY OF HEALTH AND ALLIED SCIENCES THRISSUR

In partial fulfillment of the requirements for the degree of Degree Name in Subject Name

Under the guidance of Name of the Guide

Name of the Department Name of the College Place

Year

205

DECLARATION BY THE CANDIDATE I hereby declare that this dissertation/thesis entitled <-----------------------------Title---------------------------->" is a bonafide and genuine research work carried out by me under the guidance of Name & designation of the Guide.

Signature of the candidate

Date : Place:

206

CERTIFICATE BY THE GUIDE This is to certify that the dissertation entitled <-----------------------------Title----------------------------> is a bonafide research work done by Name of the Candidate in partial fulfillment of the requirement for the degree of Degree Name.

Signature of the Guide

Date : Place:

Name

207

ENDORSEMENT BY THE HOD, PRINCIPAL/HEAD OF THE INSTITUTION This is to certify that the dissertation entitled <-----------------------------Title----------------------------> is a bonafide research work done by Name of the Candidate under the guidance of Name & designation of the Guide.

Seal & Signature of the HOD

Seal & Signature of the Principal

Name

Name

Date : Place:

Date : Place:

208

COPYRIGHT

Declaration by the Candidate

I hereby declare that the Kerala University of Health and Allied Sciences, Kerala shall have the rights to preserve, use and disseminate this dissertation / thesis in print or electronic format for academic / research purpose.

Date :

Signature of the candidate

Place:

Name

209

ACKNOWLEDGMENT

Not lengthy. Avoid Superlatives.

Date : Place:

Signature of the Candidate Name

210

LIST OF ABBREVIATIONS USED

(in alphabetical order)

211

ABSTRACT (Max. 200-300 words)

Background & Objectives

Methods

Results

Interpretation & Conclusion

Keywords (Max. 10)

Keywords shall be chosen from NuSH (Nursing Subject Headings) (Each keyword should be separated by semicolon)

212

TABLE OF CONTENTS

i. List of Tables ii. List of Figures iii. List of Graphs

i ii iii

1. Introduction

Page No.

2. Objectives

Page No.

3. Review of Literature

Page No.

4. Methodology

Page No.

5. Results

Page No.

6. Discussion

Page No.

7. Conclusion

Page No.

8. Summary

Page No.

9.References

Page No.

10. Annexures

Page No.

213

LIST OF TABLES

Sl.No

Tables

Pages

214

LIST OF FIGURES

Sl.No

Figures

Pages

215

1. INTRODUCTION

216

2. OBJECTIVES

217

3. REVIEW OF LITERATURE

218

4. METHODOLOGY

219

5. RESULTS

220

6. DISCUSSION

221

7. CONCLUSION

222

8. SUMMARY

223

9. REFERENCES
(Vancouver Format) Reference list at end of paper References should be numbered consecutively in the order in which they are first mentioned in the text; they should not be listed alphabetically by author or title or put in date order. Printed publications Book Example: Neal MJ. Medical pharmacology at a glance. Oxford: Blackwell Scientific; 1987. Rinsgiven MK, Bond D. Gerontology and leadership skills for nurses. 2nd ed. Albany (NY): Delmar Publishers; 1996. Note: Where there are more than six authors list the first six names, followed by et al. (and others). Government publication/Corporate author Example: Department of Health. Saving lives: our healthier nation. London: Stationery Office; 1999 (Cm 4386). Institute of Medicine (US). Looking at the future of the Medicaid program. Washington: The Institute; 1992. Report Example: Confidential enquiries into stillbirths and deaths in infancy. 5th Report. London: Stationery Office; 1998. Chief Medical Officer's Committee on Medical Aspects of Food. Nutritional aspects of the development of cancer. London: Stationery Office; 1998. (Department of Health report on health and social subjects 48.) Conference paper in published proceedings Example: Bengtsson S, Solheim BG. Enforcement of data protection, privacy and security in medical informatics. In: Lun KC, Degoulet P, Piemme TE, Rienhoff O, editors. MEDINFO 92. Proceedings of the 7th World Congress on Medical Informatics; 1992 Sep 6-10; Geneva, Switzerland. Amsterdam: North-Holland; 1992. p.1561-5. Journal article Example:

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You CH, Lee KY, Chey YW, Menguy R. Electrogastrographic study of patients with unexplained nausea, bloating and vomiting. Gastroenterology 1980;79:311-4. Vega KJ, Pina I, Krevsky B. Heart transplantation is associated with an increased risk for pancreatobiliary disease. Ann Intern Med 1996 Jun 1;124 (11):980-3. Parkin DM, Clayton D, Black RJ, Masuyer E, Friedl HP, Ivanov E, et al. Childhood leukaemia in Europe after Chernobyl: 5 year follow-up. Br J Cancer 1996;73:1006-12. Cancer in South Africa [editorial]. S Afr MEd J 1994;84:15. Note: Journal titles which are just a single word are not abbreviated. The titles of other journals should be abbreviated according to the style used in Index Medicus. Consult the List of Journals Indexed in Index Medicus, published in the January issue of Index Medicus. The list can also be obtained through the NLM=s web site (http://www.nlm.nih.gov). Newspaper article Example: Lee G. Hospitalizations tied to ozone pollution: study estimates 50,000 admissions annually. The Washington Post 1996 Jun 21; Sect. A:3 (col. 5).

Electronic media Individual works Example: CDI, clinical dermatology illustrated [monograph on CD-ROM]. Reeves JRT, Maibach H. CMEA Multimedia Group, 2nd ed. Version 2.0. San Diego: CMEA; 1995. Journal article Example: Morse SS. Factors in the emergence of infectious diseases. Emerg Infect Dis [serial online] 1995 Jan-Mar [cited 1996 Jun 5];1(1):[24 screens]. Available from: URL:

http://www.cdc.gov/ncidod/EID/eid.htm Computer File Example: Hemodynamics III: the ups and downs of hemodynamics [computer program]. Version 2.2. Orlando (FL): Computerized Educational Systems; 1993.

Website (Including the access date)

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10. ANNEXURES

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